HomeMy WebLinkAboutF2019-0039 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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1. Project Address (Not mailing address) Floor Suite No
7_7
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Tenant Name ' \ #Units
2. of Work
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Use
/Description
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City _
Extg Sq Ft ; New/Added Sq Ft Total Sq Ft �'
Valuation $ - - I
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Check Appropriate Box for Applicant/Notification
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F_ 3. Owner's Name Last
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i First F_,
Owner's Address
Owner's E-mail Address
City _
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Zip F7777 Telephone`
F_ 4. Architect/Designer's Name
Last
I First F Lic. No.l ,
Architect/Designees Address
Architect/Designer's E-mail Address
City _
State (---��,
Zip Telephone_--,
F, 5. Engineer's Name Last
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_ FirstWKS Lic No. l `!
Engineer's Address
Engineer's E-mail Address
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State 11;_4
Zip -�2 �'[� �. -.1 Telephone `)5/__95 3 -_ - 3 7-7
6. Contractor's Name Last
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First 5�—' Lic. No. Class
Contractor's Address
Contractor's E-mail Address
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Zip Cl;GK(,, I Telephone'7/q_goi_-7 0 C�
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OFFICE USE ONLY
PERMIT NO. N
TYPE OF CONSTRUCTION
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1' Vt'e PLAN CHECK NO. CAW
OCCUPANCY -GROUP
P AN CHECK FEE $
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