HomeMy WebLinkAboutF2020-0117 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # �— Fire Sprinkler [i Fire Alarm r1 Fire Misc
1. Project Address (Not mailing address) a a & a Floor Suite No
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Tenant Name #Units I -
2. Description of Work
Use
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Extg Sq Ft New/Added Sq Ft I Total Sci Ft
F —
Valuation $
F7 New F- Add F Alter r Demo
#Stories
Check Appropriate Box for Applicant/Notification
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F_', 3. Owner's Name Last
�- First
Owner's Address
Owner's E-mail Address
City
State F _ Zip F7777 Telephone
F_ 4. Architect/Designer's Name
Last J First Lic. No. �—
ArchitecUDesigner's Address
-Architect/Designer's E-mail Address
City
State -, Zip F7 ' Telephone
hi 5. Engineer's Name Last
First Lic. No.
- - - - - - -- -- -- -- 111
Engineer's Address
'Engineers E-mail Address
City �—
State F— Zip F__-- Telephone
Fi 6. Contractor's Name Last 1 First C>Lic. No.
Contractor's Address
Contractor's E-mail Address
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City _. ti'.[ 15_
State F� --- --. Zip �,2� S•I U Telephone '' Q611-
OFFICE USE ONLY
hJq,W1i PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PLAN CHECK NO.
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PLAN CHECK FEE $
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