HomeMy WebLinkAboutF2019-0329 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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FX 7 t_� � CA— (, iCl ' IX Fire Sprinkler F_ Fire Alarm r' Fire Misc
1. Project Address (Not mailing address)
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Floor Suite No
F 063
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Tenant Name
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2. Description of Work
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F- 5. Engineer's Name Last 116j
First C Lic. No. 147,134��
Engineer's Address
Valuation $ �! q -,v ,C6
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New/Added Sq Ft F_ Total Sq Ft � ���
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6. Contractor's Name Last, ��� (/ �' v��1e8
# Stories 17—
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F- New F_ Add
Alter F— Demo
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Check Appropriate Box for ApplicantlNotification
information
3. Owner's Name Last i ft Y v
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Owner's Address
Owner's E-mail Address
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City I� gby-t IVALtj ____— State C
Zip OWOO Telephone
r 4. Architect/Designer's Name Last �I�i `(�ijl � �', First �/1;1J(� Lic. No. t'
Architect/DesignersA�d�ddrreesss/�
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Arrc.hit'elct/Designees. E-mail A,dndr/ess
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Zip l liiJ Telephone iq %6J w(, ex
F- 5. Engineer's Name Last 116j
First C Lic. No. 147,134��
Engineer's Address
Engineer's E-mail Address
City � State I l ^ "
Zip, Telephone NI (�� dLl ll,
6. Contractor's Name Last, ��� (/ �' v��1e8
lv(�', Lic. No. ijl c Clas�'
contractor's Address
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pontractor's E-mail Address
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Zip Telephone -)`I DOJ bill em ,�q
OFFICE USE ONLY
PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $