HomeMy WebLinkAboutM2006-0014WORKSHEET FOR BUILDING I FIRE PERMIT APPLICATIO
CITY OF NEWPORT BEA9�,17,70R R[ �N 30 IC"
BUILDING DEPARTMENT,, n r.7
PLEASE PRINT OR TYPE f
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
It
Zet�FLO
OR
SUITE NO.
LEGAL DESCRIPTION
LOT BLOCK TRACT
F] 4. ARCH ITECT/DESI GN ER'S NAME LAST FIRST
LIC. NO.
No. UNITS
CHITECTIDESIGNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
F� 5. ENGINEER'S NAME LAST FIRST
2. DESCRIPTION OF WORK
ENGINEER'S ADDRESS
USE e5;.(- /54P�
# OF STORIES
VALUATION $ 72��Z- 00
SQ FT
(NEW/ADDED/EXTG)
CITY STATE ZIP
PHONE NO.
6. CONTRACT
= 1,
NEW El ADD M ALTER DEMO 1:1
Liiidt p
Check Appropriate Box for Applicant
3. OWNER'S NAME LAST FIRST
OWNER'S ADDRESS
IOWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO
F] 4. ARCH ITECT/DESI GN ER'S NAME LAST FIRST
LIC. NO.
ARCH ITECT/DESI GN ER'S ADDRESS
CHITECTIDESIGNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
F� 5. ENGINEER'S NAME LAST FIRST
STATE LIC. NO.
ENGINEER'S ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
6. CONTRACT
= 1,
BUS.INESS LIC.
7 �'(
ST A
No.
CTOR'S ADDRESS
e-0
CONTRACTOR'S E-MAIL ADDRESS
ZIP 7 -�71dt
OFFICEUSECINLY
PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
PLAN CHECK FEE $
OCCUPANCY- GROUP PLAN CHECK ENG.
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