HomeMy WebLinkAboutF2019-0170 - Permit ApplicationU-1ggqrksheet for Fire Permit ApplicationPrint Form�i^,tjit, of Newport Beach - Building 'vision Please print 3 copies �1
Associated Building Permit # ' l I' I Fire Sprinkler Fire Alarm r Fire Misc
1. Project Address (Not mailing addressjl, Floor Suite No
Tenant Name # Units �-
2. Description of Work
�!`-�l use
I Valuation $ Js
Extg Sq Ft New/Added Sq Ft Total Sq-Ft--
Add # Stories
� New � Alter � Demo
Check Appropriate Box for Applicant/Notification
Information -11,
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F-, 3. Owner's Name Last First PA I
Owner's Address Owner's E-mail Address
City �— State F__ Zip Telephoned
F_ 4. Architect/Designer's Name Last First F i Lic. No. F
Architect/Designees Address Architect/Designees E-mail Address
City State—; Zip Telephone
F_ 5. Engineer's Name Last First Lic. No.
Engineers Address Engineer's E-mail Address
City State Zip F— Telephone
6. Contractor's Name Last First r�y� vF Lic No. Class jp�l .
Contractors Address Contractors E-mail Address
City - -- State—! Zip lzS� Telephonel��-%�/�
OFFICE USE ONLY ( PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO. b16y'�lpl
OCCUPANCY- GROUP , PLAN CHECK FEE $