HomeMy WebLinkAboutF2018-0604 - Permit ApplicationFZo�-o(001-1
Worksheet for Fire Permit Application o?EWPoRa
Print Form City of Newport Beach - Building Division
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Please print 3 copies ,<�Foa,�,P
Associated Building Permit # �— JFire Sprinkler [] Fire Alarm [ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last First F
Tenant Name # Units
2. Description of Work
City F — -
_
Use
Architect/Designer's Addressr
Architect/Designer's E-mail Address
City —
I
Extg Sq Ft l New/Added Sq Ft �� Total Sq Ft �
Valuation $y�
-
New [] Add � Alter [) Demo
# Stories
Check Appropriate Box for Applicant/Notification
n 3. Owner's Name
Last First F
Owner's Address
Owner's E-mail Address
City F — -
- -� State Zip J Telephone—
F 4. Architect/Designer's Name Last _ First �— Lic. No.
Architect/Designer's Addressr
Architect/Designer's E-mail Address
City —
� State Zip C TelephoneC____1
5. Engineer's Name
Last First F-77 Lic. No. L
Engineer's Address
Engineer's E-mail Address
City—j
State Zip — TelephoneC
f,-16. Contractor's Name Last
- First Lic. No. Class C
Contractor's Address
Contractor's E-mail ss
`add
city
State Zip 5 (>,.02� Telephone',�,j
OFFICE USE ONLY
PERMIT NO.
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TYPE OF CONSTRUCTION
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PLAN CHECK NO.
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OCCUPANCY - GROUP
Ua PLAN CHECK FEE $