HomeMy WebLinkAboutF2018-0343 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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Fire Sprinkler ❑ Fire Alarm F-] Fire Misc
1. Project Address (Not mailing address)
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Tenant Name
2. Description of Work
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Extg Sq Ft 1 New/Added Sq Ft Total Sq Ft L
VNew F-, n Alter n Demo
Check Appropriate Box for Applicant/Notification
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Fl0000r Suite No
# Units L
Use 5; r,4,
Valuation $ oso.
# Stories
F_. 3. Owner's Name Last
— J First
Owner's Address
Owner's E-mail Address
City
St to Zip TelephoneF
F_ 4. Architect/Designer's Name Last
J FirstF____ _1 Lic. No.
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J
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F Zip F__7 Telephonel— __7
F_ 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
------------
City _ _
State F_-A Zip F Telephoned
[ 6. Contractor's Name Last l�%s(5 First =- Lic. No. �¢%Z3alass �(a
Contractor's Address
Contractor's E-mail Address
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City (�(�'Q.,(
State Zipg�j)- Telephone /, _�-7$^fao
OFFICE USE ONLY
V PERMIT NO.
TYPE OF CONSTRUCTION
v'S PLAN CHECK NO.
OCCUPANCY -GROUP
rY PLAN CHECK FEE $
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