HomeMy WebLinkAboutF2022-0509 - Permit Application6-P
Worksheet for Fire Permit Applicationrint Form City of Newport Beach - Building DivisionPlease print 3 espies
Associated Building Permit # <20 Fire Sprinkler )- Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name I
# Units F
2.Description of Work
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IS heads
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
New F Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
City State F Zip F_ Telephone
Use
Valuation $ Fi c) i s c )o
# Stories F
r 4. Architect/Designer's Name Last First F Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
City State F— Zip F— TelephoneF_
f 5. Engineer's Name Last I First
Engineers Address Engineer's E-mail Address
City state Zip F_ Telephone
r
Lic. No. F—
1 1
F6-Contractor's Name Lastl�p�o��-��A First �p\� Lic. No. S5,6 Class �-- �1 tp
Contractors Address \ Contractor's E-mail Address
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CityUtkt x-ov-usk State C� Zip p2,,3a TelephoneF8b1 -�Ti -(,m
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STRUCTION 1
PERMIT NO.
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PLAN CHECK NO.
PLAN CHECK FEE $