HomeMy WebLinkAboutF2019-0367 - Permit Applicationi.
Worksheet for Fire Permit Application
_C)7_6-% City of Newport Beatch - Building Division
Please print 3 copies '
Associated Building Permit #Fire Sprinkler r Fire Alarm r; Fire Misc 91
1. Project Address (Not mailing address) Floor Suite No
Tenant Name '�/ VHF n•i n� #Units
2. Description of Work
Use
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syst�l ,�s t�-�
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Extg Sq Ft �- New/Added Sq Ft Total Sq Ft
Valuation $ �
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h New F_Add � Alter r Demo
# Stories
Check Appropriate Box for Applicant/Notification
j' 3. Owner's Name Last
First ,
Owner's Address
Owwner's E-mail Address
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City i��t✓lw4-...�1`^("�
State I A --,
Zip ���LC�U Telephone Q.4./7-1���?'
4. ArchitectiDesigner's Name
Last (
FirstF— Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City I--�
State F_:
Zip I------��TelephoneF--��
1-1 5. Engineer's Name Last
'.. First F_ Lic. No, �s
Engineer's Address
Engineer's E-mail Address
City �— ...
State[--'.
Zip F Telephoned_
f7 6. Contractor's Name Last � First 7/,h, i Lic. No. WiS' -jGe Class
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Contractor's Address
Contractor's E-mail Address
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WtY c,), Vlit/
State
Zip Telephone 51'J d 1��� J
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
Xi� PAN CHECK NO.
OCCUPANCY- GROUP
r+�'L't PLAN CHECK FEE $
Oq as
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