HomeMy WebLinkAboutX2020-2697 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
B`wP0
Worksheet for Fire Permit Application ova �@
City of Newport Beach - Building Division S
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Fire Sprinkler [_ Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name
# Units
2. Description of Work
Use � -
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Valuation $ F/o ?a
Extg Sq Ft
� New/Added Sq Ft Total Sq Ft
# Stories
F New
F_ Add F_ Alter F_ Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City State �� Zip
Telephone
F_ 4. Arch itect/Designer's Name Last I
First I� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State Zip Telephone
F 5. Engineer's Name Last
First F Lic. No. F-- -
Engineer's Address
Engineer's E-mail Address
City State F Zip
Telephones
. Contractor's Name Last �/IgOA5:7—
First Lic. No. F Class F_
7 Z
Contractor's Address
Contractor's E-mail Address
City _ �_ State I�- Zipa
Telephonel �3377-?
OFFICE USE ONLY
PERMIT NO. -
TYPE OF CONSTRUCTION
PLAN CHECK NO. `-7 t S
OCCUPANCY- GROUP
PLAN CHECK FEE $