HomeMy WebLinkAboutF2019-0410 - Permit ApplicationU�eqlq,Worksheet for Fire Permit Application/��® a�/9City of Newport Beach -Building Division Fzo,Please print 3 copies
Associated Building Permit # Fire Sprinkler F_ Fire Alarm [_ Fire Misc
1. Project Address (Not mailing address)
�' First F— —'
rFloor Suite No
Owner's E-mail Address
City
State F Zip r TelephoneF-
4. Architect/Designer's Name Last
Tenant Name
Architect/Designees Address
Architect/Designer's E-mail Address
# Units
2. Description of Work
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State Zip61;gkoS;Telephone
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State Zip �� Telephoner
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Contractor's Address
Contractor's E-mail Address
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Total Sq Ft z r�
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Valuation $ '1�3�vJ ,dkj
Extg Sq Ft New/Added Sq Ft
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TYPE OF CONSTRUCTION
1�`�Z PLAN CHECK NO.
OCCUPANCY- GROUP
�� 03 PLAN CHECK FEE $
# Stories F
r New r—Add(� Alter
F—Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last I ---
�' First F— —'
Owner's Address
Owner's E-mail Address
City
State F Zip r TelephoneF-
4. Architect/Designer's Name Last
First First Lic No.1
Architect/Designees Address
Architect/Designer's E-mail Address
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City OT ll!
State Zip61;gkoS;Telephone
r 5. Engineer's Name Last
First— Lic.No.
Engineer's Address
Engineer's E-mail Address
City
State Zip �� Telephoner
F_ 6. Contractor's Name Last
First F_ � Lic. NoXWE) Class
Contractor's Address
Contractor's E-mail Address
City (}�
Stater Zip 6 Telephonejii'
OFFICE USE ONLY
G PERMIT NO. '
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TYPE OF CONSTRUCTION
1�`�Z PLAN CHECK NO.
OCCUPANCY- GROUP
�� 03 PLAN CHECK FEE $