HomeMy WebLinkAboutF2021-0284 - Permit ApplicationWorksheet for Fire Permit Application
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City of Newport Beach - Building Division g
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Associated Building Permit# XZO'ji 1 Fire Sprinkler 'j Fire Alarm rFire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Namex wv- l� #Units
2. Description of Work
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Extg Sq Ft F -----j New/Added Sq Ft F— Total Sq Ft'� /tj
Valuation $
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Check Appropriate Box for Applicant/Notification
3. Owner's Name
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Last First (------_----
Owners Address
Owner's E-mail Address
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r4.ArchitectiDesigner'sName Last First r-�---�I Lic No.r---.---
Architect/Designer's Address
Architect/Designer's E-mail Address
City
r.. Zip Telephone—__—_
State —.--
5. Engineer's Name
Last First I---.-------- Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F--.— Zip f _ Telephone[—
elephonel—j
FPS.
5. Contractor's Name Last \I � `'(F `?Z171V_ Class U0
�(ft I lOV First (( - Lic. No.
Contractor's Address1I'v\S
Contractor's E-mail Address
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OFFICE USE ONLY
�j I n PERMIT NO. 01
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TYPE OF CONSTRUCTION
�rL� `' 6 J" I� PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
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