HomeMy WebLinkAboutF2019-0192 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3copiesr?_(:)l(Di "C%P_z
Associated Building Permit # 6,Zo 1 /] _ g 3 7q K Fire Sprinkler r- Fire Alarm r Fire Misc
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1. Project Address (Not mailing address)
,First F_'
Floor Suite No
Owner's E-mail Address
City
State �— Zip �— Telephones
Tenant Name ��Bvc. ��u�� per-
Last F First F Lic. No. F
#Unit
Architect/Designer's E-mail Address
City
J_
2. Description of Work
First Lic. No. f
Use �7
Engineer's E-mail Address
I
State L..._ Zip Telephone
ir
F_ 6. Contractor's Name Last l
Extg Sq Ft�New/Added Sq Ft ��
Total Sq Ft J Q(�(�
Valuation $
# Stories
F_ New F_ Add F_ Alter F- Demo
OFFICE USE ONLY
PERMIT NO.
Check Appropriate Box for ApplicanVNotification
3. Owner's Name Last
,First F_'
Owner's Address
Owner's E-mail Address
City
State �— Zip �— Telephones
r- 4. Architect/Designer's Name
Last F First F Lic. No. F
Architect/Designees Address
Architect/Designer's E-mail Address
City
�' State I- Zip I..--- Telephone—
r 5. Engineer's Name Last
First Lic. No. f
Engineer's Address
Engineer's E-mail Address
City
State L..._ Zip Telephone
ir
F_ 6. Contractor's Name Last l
r ; �R l 061 First e -� Lic. No. Class', f -
Contractor's Address
Contractor's E-mail Address
City tl�. , {{
State G S Zip Telephone 9 i c1 JJ
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUPPLAN
CHECK FEE $