HomeMy WebLinkAboutF2019-0138 - Permit Application (3)Please print 3 copies
Associated Building Permit
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
n
'♦-71'FIreSprinkler f- Fire Alarm r Fire Misc
9
1. Project Address (Not mailing address)
Floor Suite No
+
Tenant Name
# Units F
2. Description of Work
Use
Extg Sq Ft
New/Added Sq Ft Total Sq Ft
Valuation $ �g
1vew
r" Add r Alter r- Demo
#Stories
Check Appropriate Box for Applicant/Notification
In rMnfi^.
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F--' Zip F— Telephoned
I— 4. Architect/Designer's Name Last
First Lic. No.
�—
Architect/Designers Address
Architect/Designer's E-mail Address
City F_
State F_ Zip Telephoned
f 5. Engineer's Name Last
First F—Lic. No.
Engineer's Address
Engineers E-mail Address
City
State �— Zip F—_—TelephoneF—
F—6. Contractor's Name LastX %o Firs Lic. N�cIass��� �
%%%% ///���"`���"'//!
Contractor's Address
Contractor's E-mail Address
�t��JtG ""1
City �y�"'v l
z F,,CTJeeh��
State Zip�
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $