HomeMy WebLinkAboutF2017-0491 - Permit Applicationr
Worksheet for Fire Permit Application
X City of Newport Beach - Building Division
CFORhs
Permit# _ - I _)F�_Fire Sprinkler
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Name
Description of W
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Extg Sq Ft
New C Add C Alter
W yly-2
Sq Ft Total Sq Ft
C Demo
Check Appropriate Box for ApplicantlNotification
[j Fire Alarm [] Fire Misc
Floor Suite No
# Units —
Use
Valuation $
# Stories
r73. Owner's Name Last First—'
Owner's Address Owner's E-mail Address
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City �— State F Zip Telephone
4. Architect/Designer's Name Last First Lic. No.
Architect/Designers Address
City �— State—'
Architect/Designees E-mail Address
Zip I Telephone q,/�>S3Q
r" 5. Engineer's Name Last — i _ First
Engineer's Address
City �— State
Engineers E-mail Address
Zip I-- Telephone
Lic No. —^
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Contractor's Name Last} r 2L D� Lic. No. gOjpgaxlass ip C
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C t
on ractors Address Contractors E-mail Address
City -. .Y l�-- State Zip ; Telephone _I-.7 W Jm /A) 1
OFFICE USE ONLY si �`� PERMIT NO. GO
TYPE OF CONSTRUCTION PLAN CHECK NO."�[L��
OCCUPANCY- GROUP r��l PLAN CHECK FEE $ y