HomeMy WebLinkAboutF2019-0360 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler r, Fire Alarm [ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
'- First
Tenant Name (� #Units
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2. Description of Work
City -
State F777 Zip F-77 TelephoneF—
4. Architect/Designer's Name
Last �IS ro1q First FYff ol— Lic. No. F
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Use
Valuation $ 6 i�
Extg Sq Ft � New/Added Sq Ft 3o )ii S Total Sq Ft F77777
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F_ 5. Engineer's Name Last
New F_ Add 17 Alter r Demo
# Stories
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Engineer's E-mail Address
City �_- _
Check
Appropriate -Box for Applicant/Notification
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r:. 3. Owner's Name Last
'- First
Owner's Address
Owner's E-mail Address
City -
State F777 Zip F-77 TelephoneF—
4. Architect/Designer's Name
Last �IS ro1q First FYff ol— Lic. No. F
Architect/Designees Address
Architect/Designer's E-mail Address
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City 0.1_lAY rlV .__ -----
State Zip J'Z5(�S TelephoneMIA • un -m('0
F_ 5. Engineer's Name Last
First F77777 Lic No. F
Engineer's Address
Engineer's E-mail Address
City �_- _
- StateF___ Zip F_ Telephoned
6. Contractor's Name Last �i
U� VNi First Lic. No. I�851 S Class CI�p .
Contractor's Address J
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bit VYlkf A,, OA Contractor's E-mail Address
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OFFICE USE ONLY«`��
�GI PERMIT NO.
TYPE OF CONSTRUCTION
A/ ' � /)1 PLAN CHECK NO.
OCCUPANCY - GROUP
tJ� (y(� (_J V PLAN CHECK FEE $
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IF -Z®0 ' IDN® Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I � j Fire Sprinkler r Fire Alarm rj Fire Misc
1. Project Address (Not mailing address)
Floor Suite
Owner's Address
Owner's E-mail Address
i
City
Tenant Name
4. Architect/dsigner'/
# Units
2. Description of Work
Architect/Designer's E-mail Address
city
State �— Zip --i Telephone
F— 5. Engineer's Name
Use f.
i
Engineer's E-mail Address
City �— _.,
Valuation $
Extg Sci Ft I
New/Added Sci Ft F Total Scl Ft
Contractor's Address
Contractor's E-mail Address
City �—
#Stories
New F_ Add
F_ Alter j- Demo
TYPE OF CONSTRUCTION PLAN CHECK NO. !t/Y
Check Appropriate Box for Applicant/Notification
Infn�m n4i�n
F7 3. Owner's Name
Last First F
Owner's Address
Owner's E-mail Address
i
City
State�� Zip TelephoneF�
4. Architect/dsigner'/
Name Last ��(�� 'i First 1� Lic. No. —;
ArchitecUDesigners dress
Architect/Designer's E-mail Address
city
State �— Zip --i Telephone
F— 5. Engineer's Name
Last l-- First F_f
Lic No,
Engineers
Engineer's E-mail Address
City �— _.,
State---. Zip �— Telephoner
rI6. Contractor's Name
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Last' L' F 1 �' Y � �i�1 �' First ��—' Lic No.# ?^I :��assF
L' t 1
Contractor's Address
Contractor's E-mail Address
City �—
State F_ Zip [ Telephone[���,
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO. !t/Y
OCCUPANCY- GROUP
PLAN CHECK FEE $----—��-