HomeMy WebLinkAboutF2021-0070 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
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Please print 3 copies
Associated Building Permit# ��a� _ d(�� : Fire Sprinkler ❑ Fire Alarm F-1 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name ��� # Units
2. Description of Work
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Use
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Valuation $ Q
EMg Sq Ft New/Added Sq Ft Total Sq Ft—
New Add Alter �' Demo I1YO
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#Stories F
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Check Appropriate Box for Applicant/Notification J
3. Owner's Name Last ! First,
Owner's Address
Owner's E-mail Address
city State F—,.
Zip F Telephoned—'
r7 4. Arch itecVDesigner's Name Last
First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
city State
Zip F—Telephone—
r 5. Engineer's Name Last _ _
_ First— Lic. No.
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F Telephone�—
6. Contractor's Name Last � � First Lic. No. ) 1__5 Class -/t;
Contractor's Address
Contractor's E- ail Address
City , y} State
Zip - �6 4(/ Telephone 7/ 6
OFFICE USE ONLY
PERMIT NO. fPV
TYPE OF CONSTRUCTION
PLAN CHECK NO. 0TY0261
OCCUPANCY - GROUP
PLAN CHECK FEE $