HomeMy WebLinkAboutF2021-0051 - Permit ApplicationWorksheet for fire Permit Application
City of Newport Beach -Building Division _
Please print 3 copies F2021 = W59
Associated Building Permit # �— I Fire Sprinkler rFire Alarm (;Fire Misc
1. Project Suite
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Ll�omailing Aassess) F-
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! - #Units FT
Tenant Name
2 Description of Work
city
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Extg Sq Ft r � New/Added Sq Ft F j Total Sq Ft F�t{Z
Valuation
I New r' Add r` Alter r7 Demo
# Stories
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
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city
State F I Zip Telephoner— ---.
4. Arch itectIDesigner's Name Las First ! Lic. No.
Vra�Architelt[Designers
Architect/Designees Address
E-mail Address
City i
State F Zip 7_71TelephoneF-�-_7
5. Engineer's Name Last
First (_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
Statef Zip r— Telephoner1
F-i6.Contractor's Name LastI First fao� Lic. No. �j lassrG
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Contractors Address
Contractor's E-mail Address
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State t /e —, Zip a� G.. $D�'4��!7- oaf Co
OFFICE USE ONLY
TYPE
_4d P_ PERMIT NO.
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OF CONSTRUCTION
CU PLAN CHECK NO.
OCCUPANCY- GROUP
/P� �� �n�,jy PLAN CHECK FEE $