HomeMy WebLinkAboutF2018-0128 - Permit Applicationf @ % Worksheet for Fire Permit Application
YUtb O " " City of Newport Beach - Building Division
Please print 3 copies
,Fire Sprinkler ❑Fire Alarm (- Fire Misc
Associated Building Permit # Floor Suite No
1. Project Address (Not mailing address)
___--
-__ #Units
Tenant Name--�c"�'------ ---'
2. Description of Work UseV
_ —
Valuation$ S\c
New/Added Sq Ft Total Sq Ft
# Stories
XNew [ Add (- Alter r Demo
Check Appropriate Box for Applicant/Notification
Last -
First
F7,
3. Owner's Name
Owner's E-mail Address
Owner's Address � .. -
- -
--
---'—'-- Zip Telephone
' State - ���-
City
Lic. No.
First
r 4. ArchitectlDesigner's Name Last -
Architect/Designers E-mail Address
Architect/Designers Address I
City
State F- ' Zip
__.
r 5. Engineer's Name Last
Address
First
Telephone
--
Engineers E-mail Address
�- Lic No.`T\, `
State Y(. ZAP Z.-�p Telephone _. x_\171 1 `s3ahU
City 'CO�L� `�_'c-_-."�— _ - --
�— Lic. No. �— Class.F
Fusty __._ ---- -
F- 6. Contractor's Name Last -
i Contractor's E-mail Address
Contractors
City lu r rA _f Jn✓�A
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP��
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PERMIT NO. '_ L
PLAN CHECK NO. L
PLAN CHECK FEE $