HomeMy WebLinkAboutF2018-0627 - Permit ApplicationJ !q . �1�21 Worksheet for Fire Permit Application
r /� City of Newport Beach - Building Division a \
Please print 3 copies
Associated Building Permit # X X'�l11 igto b Fire Sprinkler r', Fire Alarm r! Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
261 S _ .-_ve ----- a
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State —i Zip �— TelephoneF
F_ 4. Arch itect/Designer's Name Last First[J P Lic. No. �—
Archhiittect/ND/esigner's Address
# Units F
Tenant Name
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2. Description of Work
r-'5. Engineer's Name
Last First—Lic. No. F
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Use
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City State Zip F Telephoned—
6. Contractor's Name Last Ire � S{�y1� C I First— Lic No. q�Z({jz Class i
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Valuation $
F7,000
Extg Sq FtNew/Added
Sq Ft—. Total Sq Ft—',-
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# Stories I `
[- New [` Add
[- Alter F_Demo
PLAN CHECK
Check Appropriate Box for Applicant/Notification
)- 3. Owner's Name Last « First TW
Owner's Address
Owner's E-mail Address -
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city
City
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State —i Zip �— TelephoneF
F_ 4. Arch itect/Designer's Name Last First[J P Lic. No. �—
Archhiittect/ND/esigner's Address
Architect/Designers E-mail Address
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City �w��
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State'.... ZIP l t<7l�1 Telephoned-_—
r-'5. Engineer's Name
Last First—Lic. No. F
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Engineer's Address
Engineer's E-mail Address
City State Zip F Telephoned—
6. Contractor's Name Last Ire � S{�y1� C I First— Lic No. q�Z({jz Class i
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Contractor's Address
Contractor's E-mail Address
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OFFICE USE ONLY
PERMIT NO. �' IV� 17l ^ b('0yi
NO.
TYPE OF CONSTRUCTION
PLAN CHECK
OCCUPANCY - GROUP�V
L �g7 PLAN CHECK FEE $