HomeMy WebLinkAboutF2019-0193 - Permit ApplicationPrint FormWorksheet for Fire Permit Application
Please print 3 copes
- Oto City of Newport Beach - Building Division
copies
Associated Building Permit #
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Fire Misc Aq _I
1. Project Address (Not mailing address) Floor uite No
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Tenant Name - #Units I
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2. Description of Work
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Extg Sq Ft F New/Added Sq Ft F Total Sq Ft F
Valuation $
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["', New (— Add Alter F`' Demo
Check Appropriate Box for Applicant/Notification
F7 3. Owner's Name Last First F_
Owner's Address Owner's E-mail Address
City State F Zip (.--- TelephoneF_
F_ 4. ArchitectlDesigner's Name Last ��Y( t(v Cj K} ', First Lic. No. F - —
Architect/Designer's Address Architect/Designer's E-mail Address
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City &;�-(1/-)- r slop( �S State �Zip ci_._............._—
0(O TelephoneF
5. Engineer's Name Y Last First Lic. No. f -
Engineer's Address Engineer's E-mail Address
City State ��', Zip r Telephone
F_ 6. Contractor's Name Last din e�1CI�a First ,�� �Er^ Lic. No. FU07h Class C—(0
Contractor's Address Contractor's E-mail Address
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OFFICE USE ONLY f �l Q (,6 PERMIT NO.
TYPE OF CONSTRUCTION -112-
PLAN CHECK NO.
OCCUPANCY- GROUP 7�L � �� PLAN CHECK FEE $
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