HomeMy WebLinkAboutF2018-0320 - Permit ApplicationP'-0 l -b -020
Worksheet for Fire Permit Application �4?iWFpR�
Print Form City of Newport Beach - Building Division
Please print 3 copies o�«
OPeP
Associated Building Permit # Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name # Units L
2. Description of Work
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Use
Valuation $
#Stories 7
j—'� 5 v Z
Extg Sq Ft J New/Added Sq Ft Total Sq Ft
New 17 Add ❑Alter ❑Demo
check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last C First
Owner's Address - Owner's E-mail Address
City �— State F — Zip Telephone—
❑! 4. Architect/Designer's Name Last First �— Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
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City State [7-7 Zip F7— — Telephoned
❑ 5. Engineer's Name Last �— First F777-7 Lic. No.
Engineer's Address Engineer's E-mail Address ����JJJJ
City - _ State �— Zip F� Telephoned
6. Contractor's Name Last � First A��% Lic. No.( f Class ; F
Contractor's Address Contractor's E-mail Address
City ` _ I
Telephone-�2�!StateeAZi
OFFICE USE ONLY PERMIT `// % l
TYPE OF CONSTRUCTION V / i/ �y
01�} PLAN CHECEC K NO. ��' I.i"
OCCUPANCY - GROUP11.� _� 1f.\ PLAN CHECK FEE $