HomeMy WebLinkAboutF2018-0401 - Permit Application1691-018
Worksheet for Fire Permit Application F,W19.01401
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # F -j Fire Sprinkler F, Fire Alarm K'Fire Misc
1. Project Address (Not mailing address) Floor Suite No
— ----- ------ -- ------
Tenant Name # Units
2. Description of Work
Owner's E-mail Address
Dy_ 2 C) o
Use
Valuation $ FF1 EZ
Extg Sq Ft New/Added Sq Ft Total Sq Ft
r;New r- Add F_ Alter F_ Demo
# Stories 17
Check Appropriate Box for Applicant/Notification
'3.Owner's Name Last
First F�
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Owners Address
Owner's E-mail Address
Dy_ 2 C) o
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City
State
17c�7
zip r;T� TelephoneFc, I, �r C3
F-4. Architect/Designer's Name
Last
FirstF Lic. No. F
Architect/Designees Address
Architect/Designers E-mail Address
F 7
city
State
ZipF Telephone
5.
XEngineer's Name Last
First Mcw_L cr) Lic. No.
FT
Engineers Address
Engineers E-mail Address
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City
State ICA
Zip 9T�(,T TelephoneFqq_L4.0_0 t to
6. Contractor's Name Last
Lic. No. F -Class'
FirstF
Contractors Address
Contractor's E-mail Address
City--,
State
zip Telephone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $