HomeMy WebLinkAboutF2017-0230 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # F-
1. Project Address (Not mailing address)
Sprinkler r Fire Alarm F- Fire Misc
Floor jSuit�eNo'
— 1
Tenant Name
2. Description of Work
LA
Sq Ft New/Added Sq Ft -� r W" - 1— Total Sq Ft
,tr i New r Add r Alter F_ Demo
Check Appropriate Box for Applicant/Notification
# Units
Use I V ._,
Valuation $ st
# Stories
I- 3. Owner's Name Last F—
�—
First
Owners Address
Owner's E-mail Address
City �— State �—
Zip Telephone—
4. Architect/Designer's Name Last M rt First 1 �j( Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
I
City State
I
Zip F Telephone!;
5. Engineer's Name Last
First ILic. No.
Engineers Address
Engineers E-mail Address
City State
--
Zip �— Telephone! i
. Contractor's Name Last-t- .`(}IJ,r First Lic No. �IasslC� (� C
re'"'t tip
Contractor's Address
Contractor's E-mail Address
�J
MAI
City �'��. State iGA,
i
Zip Telep hone; 7I-�/✓(/` I
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION n� 16,
OCCUPANCY - GROUP 1�/)
0/0-�, PLAN CHECK NO.A/ ® I /)
PLAN CHECK FEE
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