HomeMy WebLinkAboutF2019-0091 - Permit ApplicationV7_1_o1ct C:c 7i I
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - BuildjI22 Divisions /
X' Fire Sprinkler [I Fire Alarm (I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name ��,�� ` I #Units
2. Description of Work
Owner's E-mail Address
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4. Architect/Designer's Name Last
Extg Sq Ft New/Added Sq Ft Total Sq Ft 'I
Valuation $3'7t I
New F_ Add r... Alter F– Demo
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Check Appropriate Box for Applicant/Notification
r', 3. Owner's Name Last
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Owner's Address
Owner's E-mail Address
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City
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Zip Telephoned
4. Architect/Designer's Name Last
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First F---', Lic. No. F
- Architect/Designees Address
Architect/Designer's E-mail Address
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Zip r---- Telephone
F_ 5. Engineer's Name Last
First-- F
Lic. No.
Engineer's Address
Engineer's E-mail Address
City—
State �_—
Zip F Telephone
r76. Contractor's Name Lastio�5��
First'��i. Lic. No. -,bey Class
Contractor's Address
Contractor's E-mail ddress
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OFFICE USE ONLY
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\/, $ �� PERMIT NO. {a
TYPE OF CONSTRUCTION
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5fr
PLAN CHECK NO. �'
OCCUPANCY- GROUP
PLAN CHECK FEE $