HomeMy WebLinkAboutF2020-0499 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies City of Newport Beach - Building Division
Associated Building Permit # j [— Fire Sprinkler i i Fire Alarm r Fire Misc
1_Project Address (Not mailing address)
--T7
Tenant Name
2. Description of Work
Extg Sq Ft F New/Added Sq Ft F
L .i New r d r' Alter F- Demo
^FF. �Fl uw rug P%wilGanuimorarication
Total Sq Ft
Floor Suite No
C '
_. _:
# Units
Use
Valuation $ [if
- -I
# Stories
3. Owner's Name Last
Ma��pu� First
Owner's Address
Owner's E-mail Address
- -
City
-- .. - -
State Zip F— Telephone- --'
F- 4. Arch itect/Designer's Name Last
First Lic. No.
vv ! C
Architect/Designer's Address
Architect/Designer's E-mail Address
City f
p q Telephone _ �rQ3�/�91'
State _, Zi /c) ! I/ ( b FSv
177 5. Engineer's Name Last
FirstF------
Lic No. �--_-
Engineer's Address
Engineer's E-mail Address
City
- -
State I Zip F Telephone:
P
r16. Contractor's Name Last First Lic. No. �` fl! Class
Contractor's Address I 1
Contractor's E-mail Address
City r
y W c(
-� p
State �d''�- Zip � Telephone�[ L
(� C�
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION d
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $