HomeMy WebLinkAboutF2018-0233 - Permit ApplicationPlease print 3 copies
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Associated Building Permit # ; Fire Sprinkler [ Fire Alarm ri Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name # Units L
2. Description of Work
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Use �......__-...__._ '..
Extg Sq Ft F_I New/Added Sq Ft Total Sq Ft �',
Valuation $-Ipl c
(l 4. Architect/Designer's Name
# Stories
III ,
New F_ Add F_ Alter i--- Demo
Architect/Designers Address
Check Appropriate Box for Applicant/Notification
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j—! 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address -
City �— _
_,, State Zip
F Telephone
(l 4. Architect/Designer's Name
Last
First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City I
State F_ Zip Telephoned
F 5. Engineer's Name Last
First Lic No. F
Engineer's Address
Engineer's E-mail Address
i
City I -- -
State F_. Zip
F Telephone
6. Contractor's Name Last s
First j Lic. No. � lass
Contractors Address
-
Contractor's E-mail Ares
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City
State Zip
Telephon
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OFFICE USE ONLY
PERMIT NO. I a 0 t3
TYPE OF CONSTRUCTION
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PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $