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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 ----- -- n4-. -- - City - — .- State �— Zip Tenant Name # Units 2. Description of Work Architect/Designer's E-mail Address ----------- --- �— ----- 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 _�-_.�' ,--�h,�--rte 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 ----------- --- �— ----- 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 _�-_.�' ,--�h,�--rte City IrJ`� State Zip Telephone'J���� OFFICE USE ONLY PERMIT TYPE OF CONSTRUCTION / PLAN CHECK NO. OCCUPANCY- GROUP PLAN CHECK FEE $