HomeMy WebLinkAboutF2018-0420 - Permit Application�� A
Worksheet for Fire Permit Application a�`'�`°"'m
City of Newport Beach - Building Division o
Please print 3 copies (j�� „► S c""°""�P
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Associated Building Permit# �— ! Fire Sprinkler vj--'Fire vAlarm r7 Fire Misc,�
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1. Project Address (Not mailing address)
Last
Floor Suite No
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Owners E-mail Address
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Tenant Name ���..
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# Units F
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2. Description of Work
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Name Last �—
;First 'Lic. No.
Architect/Designer's Address
Valuation $00
Extlq Sq Ft New/Added Sq Ft j Total Sq Ft F'!.
-
State F_Zip
Telephoned
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# Storie�
New r— Add F— Alter F
Demo
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Check Appropriate Box for Applicant/Notification
F– 3. Owner's Name
Last
Owner's Address
Owners E-mail Address
CityF— -...
__ ! State Zip
�— Telephoned–
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F_4. Architect/Designer's
Name Last �—
;First 'Lic. No.
Architect/Designer's Address
ArchitecVDesigner's E-mail Address -
City
State F_Zip
Telephoned
F_ 5. Engineer's Name
Last
:First—, Lic. No.l
I
Engineer's Address
Engineer's E-mail Address
ciityy
State �— Zip
�– Telephoned
1, Contractor's Name
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Last f!%
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First F_ Lic. No. 5, -?-fec s 6-5-
Contractor's Address
Contractor's E -mai ddress
City //���
State l 7--; Zip
!� Telephone , ] [
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PERMIT NO. Liu nb 0
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $