HomeMy WebLinkAboutF2020-0470 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
ire Sprinkler ❑Fire Alarm nFire Misc
1. Project Address (Not mailing address)
Fr
Floor Suite No
Tenant Name
# Units
2. Description of Work
Use
/`t
ExIg/Sq Ft
New/Added Sq Ft �i Total Sq Ft
Valuation $ �S
e New (— Add r
Alter r Demo
# Stories'
Check Appropriate Box for Applicant[Notification
(-i 3.Owner's Name Last
First•
Owner's Address
Owner's E-mail Address
City �—
State —'I
Zip—' Telephone--
(- 4. Arch itectfDesigner's Name Last
�--
First Lic. No.
Architect/Designers Address
Architect/Designers E-mail Address
City -,
State
Zip F___71 TelephoneF-
5. Engineer's Name Last -
First Lic. No.
Engineers Address
Engineers E-mail Address
City
State--
zipF_7�! Telephoned
6. Contractor's Name Last
First Lic. No. 3231(a Class G-(
Contractors Address
Contractors E-mail Address
.201 -_. _0
City - % - /I�cw
State FX7
Zip q Telephone. _7-idiG�U
OFFICEUSEONLY
TYPE OF CONSTRUCTION
�Z P E R M I T N • O (
I
911f 106W
I77�Rii
j PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $ I LNS��
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