HomeMy WebLinkAboutF2019-0034 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies l?",
Associated Building Permit #
F7, Fire Sprinkler ri Fire Alarm n Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
Owner's Address
Tenant Name `'C�-�.. C' # Units F-
2. Description of Work)
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Extg Sq Ft I New/Added Sq Ft �_ Total Sq Ft
Valuation $ 13-:
Designer's Name Las
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�! New I` Add F— Alter I— Demo
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Check Appropriate Box for Applicant/Notification
(3. Owner's Name Last SL i First,
Owner's Address
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`bw er's E-mail Address
City p
State �e
Zip (F Telephoner—
Designer's Name Las
1 (L—
Fire Lic. No.
ArchitectiDesigners Address
ArchitecUDesig -mail AddWs
City r-
State
Zip Telephoned
F—, 6. Engineer's Name Last
First r— Lic. No —
Engineer's Address
Engineer's E-mail Address
City r- _._/ .
State
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Zip F—� Telephoner----.,
�}6. Contractor's Name La stC
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First r Lic. No. r — r_ --
ng Class CjO
Contractor's Address '' \ '
Contractor's E-mail Address
city -
State ��
Zip n Telephone
-1 ,Iv^�Li}S LIQ j
OFFICE USE ONLY
%t PERMIT NO.
TYPE OF CONSTRUCTION
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- PLAN CHECK NO. ' 1
OCCUPANCY- GROUP
PLAN CHECK FEE $
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