HomeMy WebLinkAboutF2021-0387 - Permit ApplicationFirm7771 Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies 6.3 �f
7
Associated Building Permit # F XFIre Sprinkler F_ Fire Alarm [7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant NameIUnits r
-
2. Description of Work
Use
Valuation $Rqb_
Extg Sq Ft F New/Added Scl Ft F Total Sq Ft F
New r Add F Alter Demo # Stories
Check Appropriate Box for Applicant/Notification
r,7 3. Owner's Name
Last First F)aZ
Owners Address
Owner's E-mail Address
City ---
State
Zjj�Telephone F
F.-A Architect/Designer's Name Last
F777777777
First r Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
ZIP TelephoneF_
FJ_ 5. Engineer's Name
Last F
First F Lic. No. F
Engineer's Address
Engineer's E-mail Address
City �—_—
State
Z!pF TelephoneF
C6.Contractors Name LastLh_
First Lic. No. Class FS14,ntractor's
Address
I 13�,5 N
C;Qnl
Contractors E-mhtl Address
City
State I
zip Telephone 1) Z
3
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $
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