HomeMy WebLinkAboutX2019-3625 - Permit ApplicationoV I l!- 362-5 F 2
Worksheet for Fire Permit Application
rt Forms City of Newport Beach - Building Division
print 3 copies
Building Permit # F- Fire Sprinkler F_ Fire Alarm F, Fire Misc
1. ProjectAddress(Not mailing address) Floor Suite No
F
Tenant Name QIfes. Q L,wL 1 _.. # Units
2. Description of Work
Use
Owner's E-mail Address
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Total Sq Ft �------I
EMg Sq Ft �New/Added Sq Ft F - Total
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New r Add F j Alter F_ Demo
# Stories l �-----
Check Appropriate Box for Applicant/Notification
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F_ 3. Owner's Name Last
First F_
Owner'sAddress
Owner's E-mail Address
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City ,,.
State
Zip f ---- Telephoner
F-,4. Architect/Designer's Name Last
_- Lic. No. �—
First F_
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State F__
zip r—! Telephone) --
r 5. Engineer's Name Last
First— Lic. No.
Engineer's Address
Engineer's E-mail Address
City .,._ ,.
State F
Zip F Telephoned—-
Lic. NClass
F-6. Contractor's Name Lastst G�'�_ o d� e
Contractor's Address
Contractor's E-mail Address
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city (.<�� r� ��
State I C
Zip ���� TEle�hone 337 33/2
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
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PLAN CHECK NO.
OCCUPANCY -GROUP
X ' -
rl, PLAN CHECK FEE $
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