HomeMy WebLinkAboutF2018-0599 - Permit ApplicationPrint Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies Al=� PtN
Associated Building Permit# ❑ Fire Sprinkler ❑Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
29'77- F 7
Tenant Name # Units L
2. Description of Work
Use
I
Extg Sq I Ft �1 New/Added Sq I Ft � Total Sq Ft �J
Valuation $
# Stories
❑ New r-] Add F] Alter rDemo
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
City State F _7 Zip F-77 TelephoneF777_7
4. ArchitectlDesigner's Name Last _ First� Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
F 71
— -----
City -_ _ State F-7 Zip 7_7 Telephoned
❑ 5. Engineer's.Name Last First Lic.No.�
Engineer's Address Engineer's E-mail Address
City _ 1 State Zip ----] Telephoned
❑ 6. Contractor's Name Last C� f n�C� First tel? Lic. No. Classa 0-
— 7
Contractor's Address Contractor's E-mail Address /
city{T� _ State ® Zip �� Telephoned
OFFICE USE ONLY PERMIT NO. `--2-�D
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP PLAN CHECK FEE $
1)