HomeMy WebLinkAboutREV2024-1490 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# F-I Fire Sprinkler ❑ Fire Alarm j-1 Fire Misc
1. Proiect Address (Not
Tenant Name
2. Description of Work
Extg Sq Ft New/Added Sq Ft �! Total Sq Ft�
Fj New F_ Add ❑ Alter F__ Demo
Check Appropriate Box for Applicant/Notification
oa
Floor
Suite No
IfUnits
I
Valuation $
# Stories
F'� 3. Owner's Name Last First F7777—
Owner's Address
Owner's E-mail Address
— -----------
City
State �� Zip Telephoned
4. Architect/Designer's Name Last First— Lic. No.r
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F—. Zip Telephoned
(_ 5. Engineer's Name Last _
_ First Lic. No.
Engineer's Address
Engineer's E-mail Address
i
City _
State F Zip 7 TelephoneF
E6. Contractor's Name Last
lL� --� First Lic. No. *3- `Class—!
Contractor's Address
Contractor's E-mail Address
i/Sbo S7-e¢Z.,25 IjV
-- %wC Gd
CityL--.21ye- s';,&
State E, Zip _ZSo.3 -_ Telephone 7/Y-
OFFICE USE ONLY
PERMIT NO. b/
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $