HomeMy WebLinkAboutF2019-0147 - Permit ApplicationPlease print 3 copies
Associated Building Permit
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
eSprinkler ❑ Fire Alarm M Fire Misc
t. Project Address (Not mailing address) Floor Suite No
Tenant Name —\�9 nits F
2. Description of Work
Use
Extg Sq Ft �—I New/Added Sq Ft �� Total Sq Ft F
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Valuation $
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Check Appropriate Box for Applicant/Notification
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3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City I
! State
Zip F Telephoned ,
4. Arch itect/Designer's Name Last First Lic, No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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F 5. Engineer's Name
Last
First— Lic.No.�—_
Engineer's Address
Engineer's E-mail Address
City
State
Zip Telephone
6. Contractor's Name Lash
Lic. No. Class l� L
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Contractor's Address
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Contractor's gs
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City
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State
Zip Telephone
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
V
PLAN CHECK NO:
OCCUPANCY - GROUP
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PLAN CHECK FEE $
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