HomeMy WebLinkAboutF2020-0463 - Permit ApplicationWorksheet for fire Permit Application
City of Newport Beach - Building Division V.20,QD- d 1463
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Associated Building Permit p Z V, Zg ra [7, Fire Sprinkler ftR�Fire Alarm j7; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
( First—
Tenant Name I r , C�e cZ j # Units
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2. Description of Work
City State
ZIP Telephone 7
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Extg Sq Ft `q , New/Added S Ft O Total S Ft
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Valuation$ 12 .Onv I
New r; Add Alter F7 Demo
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Engineer's Address
Check Appropriate Box for Applicant/Notification
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r.-'3. Owner's Name Last �—
( First—
Owner's Address
Owner's E-mail Address
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City State
ZIP Telephone 7
(- 4. Arch itecUDesigner's Name Last �— I First F Lic No. F�
ArchitectlDesigner's Address
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ArchitecUDesigner's E-mail Address
City State—
Zip---� Telephone
[i 5. Engineer's Name Last First-
-_.._ Lic. No. �V
Engineer's Address
Engineer's E-mail Address
City - State
�- Zip F— Telephone(
6. Contractor's Name Last 7 First �Lt�- � --- Lic. No. p
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Coonntractor's Address
Contractor's E-mail
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City ✓ State
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY -GROUP
PLAN CHECK FEE$