HomeMy WebLinkAboutF2021-0353 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application gy
City of Newport Beach - Building Division
j- Fire Sprinkler [ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name_r. /__. _.. ......_ #Units-.------.-�
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2. Description of Work
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Use
EMg Sq Ft �- New/Added Sq Ft F_ Total Sq Ft
Valuation $ Fl/ 7(/(/
New Add Demo
# Stories
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5. Engineer's Name
Check Appropriate Box for Applicant/Notification
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(- 3. Owner's Name
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Owner's Address
Owner's E-mail Address
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[i 4. Arch itect/Designer's Name Last i First F Lic. No. r--
Architect/Designer's Address
A chitectlDesgner's E-mail Address
City
State F Zip Telephoned
5. Engineer's Name
Last � 10 p ,' First — Lic No.
Engineer's Address
Engineer's E-mail Address
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State F__ Zip F— TelephoneF_
F_ 6. Contractor's Name Last yjJ First F— Lic. No. 2�i5 [,3 Class-
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Contractor's Address
Contractor's E-mail Address
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OFFICE USE ONLY
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TYPE OF CONSTRUCTION
PLAN CHECK Nn
OCCUPANCY- GROUP
PLAN CHECK FEE $