HomeMy WebLinkAboutF2017-0145 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# II,/Fire Sprinkler E7,." Fire Alarm
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F*,02011.0145
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1. Project Address (Not mailing address) Floor Suite No
# Units E__
Tenant Name
2. Description of Work
Use
Valuation $
E xtg Sq Ft
1 1 New/Added Sq Ft Total Sq Ft
4 Stories
New �R Add Alter F Demo
Check Appropriate Box for Applicant/Notification
[713. Owner's Name Last First
Owner's Address Owner's E-mail Address
City State zip TelephoneF777777
F
F74.Architect/Designer's Name Last Lic. No.
First
Architect/Designer's Address Architect/Designers E-mail Address
city State E_ Zip Telephone
[715. Engineer's Name Last First
L__ Lic. No.
F
Engineers Address Engineer's E-mail Address
Zip Telephone
City State L
F,16. Contractor's Name Last First rJ4,ti Lic. No, Class IT
Contractor's Address Contractor's E-mail Address
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City[<Xti/� -egl7efill State Zip[ Zj q06
FC0 Telephonf7
`,=ICE USE ONLY PERMIT NO.
�E OF CONSTRUCTION
PANCY- GROUP PLAN CHECK FEE !9
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