HomeMy WebLinkAboutF2019-0156 - Permit ApplicationPrint Form y Worksheet for Fire Permit Application
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�2o 1 q _ n 1 Sko City of Newport Beach - Building Division
Associated Building Permit# 6vt� �x K Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
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Tenant Name
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#Units
2. Description of Work
Architect/Designer's E-mail Address
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Use
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New/Added Sq Ft Total Sq Ft 0 o
Valuation $
City
State I--- Zip F', Telephoned
# Stories a
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Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last �� Firsts
Owner's Address
Owner's E-mail Xddress
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F_ 4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F_' Zip I Telephoned
5. Engineer's Name
Last First I Lic No. (
Engineer's Address
Engineer's E-mail Address
City
State I--- Zip F', Telephoned
f— 6. Contractor's Name Last First �� \ 1 Lic. No. I 10 0-181 Class FC - -1y '
Contractor's Address
Contractor's E- 'I Address
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OFFICE USE ONLY
PERMIT NO. 11 0I1-:70
TYPE OF CONSTRUCTION
PLAN CHECK NO. 0015
OCCUPANCY - GROUP
- 1 /�� .1� PLAN CHECK FEE $