HomeMy WebLinkAboutF2019-0064 - Permit Application�ZO�°l-COC �i Worksheet for Fire Permit Application 1 �W"�
City of Newport Beach - Building Division
Please print 3 copies / �<, oa�P
Associated Building Permit # n Fire Sprinkler _j/Fire Alarm rl Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last
Tenant Name # Units F
2. Description of Work
Use
AA
IYwI
\v Ver;
Extg Sq Ft New/Added Sq Ft —I Total Sq Ft —j
Valuation $
Zip Telephone
t
#Stories
r7 New r Add r Alter r Demo
FirstLic. No.l
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last
iFirst F—
Owner's Address
i
Owner's E-mail Address
City
State ��
Zip Telephone
t
4. Architect/Designer's Name Last
FirstLic. No.l
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip Telephone
F 5. Engineer's Name
Lastl..,
First �— Lic No.
F_
Engineer's Address
Engineer's E-mail Address
City
State
Zip Telephone
F-6. Contractor's Name Last_
First-- Lic No.'b Class—,
Contractor's Address
Contractor's E-mail Address
City--
State
Zip F—' TelephoneF___
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
7
PLAN CHECK NO. L�
OCCUPANCY- GROUP
PLAN CHECK FEE $