HomeMy WebLinkAboutF2021-0586 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# [7, Fire Sprinkler F,l Fire Alarm
F—I Fire Misc
015 ON
2-M
1. Project Address (Not mailing address)) Floor Suite No
First
Tenant Name # Units
2. Description of Work
Owner's E-mail Address
City state
7_7
Zip—i Telephone[
Extg Sol Ft New/Added Sq Ft Total Sq Ft
I I
Valuation $
-
FV New F_ Add [7, After F7 Demo
# Stories FT
Check Appropriate Box for Applicant/Notification
Fj 3. Owner s Name Last
First
Owner's Address
Owner's E-mail Address
City state
7_7
Zip—i Telephone[
F_
.1 4. Architect/Designer's NameLast ,
First
J, F Lic, No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
zip Telephone
5. Engineer's Name Last
First Lic. No.
F_71
Engineer's Address
Engineer's E-mail Address
City State
zip F_ Telephone
fv_�6. Contractor's Name Last l I First Fk7 A- Lic. No. Class
- - ---- ------- - -------
Contractor's Address
Contractor's E-mail, , ------
City State F_
Zip Telephorej
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. ,7
OCCUPANCY - GROUP
PLAN CHECK FEE $ -