HomeMy WebLinkAboutF2018-0426 - Permit Application (2)F-ZO 1�b- o L-IZ�
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler [ Fire Alarm [ Fire Misc
1. Project Address (Not mailing address)
o Suite No
Owners E-mail Address
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Tenant Name
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#Units
2. Description of Work
Zip :.. Telephone—I
Use f - -
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Valuation $ (oJ77ll u?
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Extg Sq Ft F
New/Added. Sq Ft �— Total Sq Ft F
[7New
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F_Add Alter F -Demo /UI U
# Stories
First F777777 Lic No. r—'
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Check Appropriate Box for Applicant/Notification
f— 3. Owner's Name Last ` ({ First F
Owner's Address�p�,
Owners E-mail Address
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City ����� State
Zip :.. Telephone—I
F- 4. Architect/Designer's Name Last
i First—' Lic. No. '
Architect/Designees Address
Architect/Designer's E-mail Address
City _.. State—
Zip F_ Telephone
F_ 5. Engineer's Name Last
—
First F777777 Lic No. r—'
Engineer's Address
Engineer's E-mail Address
City ._ State
F—.
Zip F Telephonel—
F 6. Contractor's Name Last A n C �
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First ; k ((� Lic. No. g6(„2Y� Class ? (Cv
Contractor's Address
Contractor's E-mail Address
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City �rkv U( _ State
Zip p��(, Telephone ,Cyy�_ ) T3/
OFFICE USE ONLY
PERMIT NO. '
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $