HomeMy WebLinkAboutF2019-0530 - Permit Application61 _ O� Worksheet for Fire Permit Application
3b City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I Fire Sprinkler j7 Fire Alarm F. -i Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
700 I
# Units 1
Tenant Name ("ne,�� C L t-�A, J.4 _ )
2. Description of Work
Use
Owner's E-mail Address
JJ
StateI Zip Telephone��
Sq Ft New/Added Sq Ft Total Sq Ft F
Valuation $�0 0_Extg
F7 New F7 Add /Alter �, Demo
# Stories
Check Appropriate Box for Applicant/Notification
Information
3. Owner's Name
Last I
First',
Owner's Address
Owner's E-mail Address
City
StateI Zip Telephone��
F_ 4. Arch itecUDesigner's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State �— Zip
FI TelephoneF_
[i 5. Engineer's Name
Last
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
_ State [ Zip
F-1 Telephone
j 6. Contractor's Name Last
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First F —' Lic. No. �7 Z ��� Class C
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Contractor's Address
Contractor's? E-mail Address
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City
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OFFICE USE ONLY
PERMIT NO. �� O
TYPE OF CONSTRUCTION
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PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $