HomeMy WebLinkAboutF2020-0074 - Permit ApplicationWorksheetfor Fire Permit Application oF�Ewae
Please print 3 copies
City of Newport Beach - Building Division h /� 3
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Associated Building Permit # )Fire Sprinkler r! Fire Alarm n Fire Misc
1. Project Address (Not mailing address)Floor Suite No
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Tenant Name f--- -� l j # Units
2 Description of Work
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City _-_
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StateF77F7777
Valuation $
Extg Sq Ft F , New/Added Sq Ft Total Sq Ft F
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': First Lic. No, r---'
# Stories F) l0
New j—I Add r Alter [_Demo
Architect/Designer's E-mail Address
Check Appropriate Box for Applicant/Notification
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F7 3. Owner's Name Last
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Owner's Address
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Owner's E-mail Address
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StateF77F7777
Telephone
F- 4. Architect/Designer's Name Last
': First Lic. No, r---'
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State-
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Zip F Telephone
(- 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
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State —
Zip F—' TelephoneF
Fv;6. Contractor's Name Last SZAI�l6ErON First F7hFfjf Lic. No. F667�/ class /G
Contractor's Address
Contractor's E-mail Address
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Zip f 11331 Telephone[&(g - ZS2-S7!�r/
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OFFICE USE ONLY
PERMIT NO. (n�_VQ ° )
TYPE OF CONSTRUCTION
PLAN CHECK NO. Dt!A1
OCCUPANCY - GROUP
����� PLAN CHECK FEE $