HomeMy WebLinkAboutF2018-0611 - Permit ApplicationPrint Form Worksheet for Fire Permit App ication
City of Newport Beach - Building Division
Please print 3 copies \�, { 1.50,0 P6 V
Associated Building Permit#--� n Fire SprinklervJ(—j❑�/<)Fire Alarm [i Fire Misc 7
1. Project Address (Not mailing address) Floor Suite No
Tenant Name 17,t# # Units
-
2. Description of Work
'
Use
VT72
Valuation $
Extg Sq Ft New/Added Sq Ft �� Total Sq Ft ��
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I, " � New Add Alter Demo
# Stories
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name LastFirst F7___7
Owner's Address Owner's E-mail Address
City _ _ __ state Zip �— Telephone��
❑ 4. Architect/Designer's Name Last C First 177— Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City _ - State F — Zip C__� Telephoned
❑ 5. Engineer's Name Last �— I First F7777 Lic. No.l
Engineer's Address Engineer's E-mail Address L_1
City State �— Zip �— Telephoned
❑ 6. Contractor's Name LastL111�11C_r 4—First r ( Lic. No. � Class
Contractor's Address Contractor's E-mail Address "9
7uLSTST, // G12 7i
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City � State l.Li�� Zip /�21P� aET 53%%
OFFICE USE ONLY ter/ PERMIT NO.
TYPE OF CONSTRUCTION > , ,p i4� PLAN CHECK NO. ZI f-1 40' 2-01 A
OCCUPANCY - GROUP �� //�� PLAN CHECK FEE $
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