HomeMy WebLinkAboutF2018-0549 - Permit Applicationra Lv - Mq
Worksheet for Fire Permit Application o�"` "°Rm
Print Form City of Newport Beach - Building Division
Please print 3 copies ;:oa„.=
Associated Building Permit # sIA)611� ❑ Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing addrrpess),
Floor Suite No
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-- n4-. -- -
City - — .- State �— Zip
Tenant Name
# Units
2. Description of Work
Architect/Designer's E-mail Address
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7StatF
-- 1 ---
�City hone E_771
❑ 5. Engineer's Name Last �—
Use
Engineer's Address
Engineer's E-mail Address
City �— State Zip
[ Telephone��
6. Contractor's Name Last / /lG�ln do e /' 1
Valuation$
Extg Sq Ft
New/Added Sq Ft _ _Total Sq Ft
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City IrJ`� State Zip
# Stories
❑ New r7 Add
❑Alter ❑ Demo
TYPE OF CONSTRUCTION / PLAN CHECK NO.
Check Appropriate Box for Applicant/Notification
InFi..ro�4'i.n
3. Owner's Name Last C
First
Owner's Address
Owner's E-mail Address
City - — .- State �— Zip
F___71 Telephone
❑ 4. Architect/Designer's Name Last
First F7 Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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7StatF
-- 1 ---
�City hone E_771
❑ 5. Engineer's Name Last �—
First Lic No.
Engineer's Address
Engineer's E-mail Address
City �— State Zip
[ Telephone��
6. Contractor's Name Last / /lG�ln do e /' 1
First _ y Lic. No. Class Fa T6
Contractor's Address
Contractor's E-mail Address
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City IrJ`� State Zip
Telephone'J����
OFFICE USE ONLY
PERMIT
TYPE OF CONSTRUCTION / PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $