HomeMy WebLinkAboutF2020-0025 - Permit ApplicationWorksheet for Fire Permit Application
F�D/X e O® �Ci of Newport Beach -Building Division
Please print 3 copies ��
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Associated Building Permit # FP-rl re Sprinkler [ FFtre Alarm I j Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant NameF/-
,�,1 (� -(i� S�r'�ii�-- ��J'1 Units -_CSI #� - -i
2. Description of Work
Use
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Extg Sq Ft New/Added Sq Ft I Total Sq Ft i
ew r; Add � Alter r Demo
Valuation $ 3L19.r
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# Stories
Check Appropriate Box for Applicant/Notification
(-i 3. Owner's Name Last—
First;
Owner's Address
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Owner's E-mail Address
City �— State
zipZip Telephone
F_ 4. Architect/Designer's Name Last j First F Lic. No. F --"
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ArchitecUDesi ner's Address
9
Architect/Designer's-- -
E-mail Address
City State—'
Zip F ----_I Telephone
F, 5. Engineer's Name Last GG
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First Lic. No.
Engineer's Address
Engineer's E-mail Address
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City _l%f Q.✓�1 --.- - -----__.- State (
Zip q0eb Telephone -( (-70?-%.-�U�LI>..i
[7.`6. Contractor's Name Last LiNo.���Class
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Contractor's Address
Contractor's E-mail Address
—
City � ( G� State
Zip 1 Telephone -'J�v7 _�
2 �Y- C
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP �`l�° 2�
PLAN CHECK FEE $ W.
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