HomeMy WebLinkAboutF2020-0234 - Permit ApplicationaiWFORJ
®may Worksheet for Fire Permit Application a
5_ TLt �, City of Newport Beach - Building Division
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A�«, intprl Ruildino Permit # ,Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing
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Tenant Name
2. Description of Work
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Extg Sq Ft New/Added Sq Ft 5 73-( 3 Total Sq Ft s (p3
New [-. Add r! Alter r Demo
Check Appropriate Box for Applicant/Notltication
r', 3. Owner's Name Last First
Floor Suite No
# Units
Use
Valuation $ Vol 4_n
# Stories 1 —
Owner's Address Owner's E-mail Address
City State F Zip Telephone[�
r 4. Architect/Designer's Name Last
Address
First—', Lic. No.I
E-mail Address
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City �— ,
State Zip �� Telephoned'
r 5. Engineer's Name Last F— First Lic. No. F—,
Engineer's Address Engineer'sE-mail Address
City �— State Zip TelephoneF—
. Contractor's Name Last QLrSl9G mpl U_Fl" 61WWA3', First, Lic. No. ;B641- S' Class Of
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Contractor's Address Contractor's E-mail Address
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OFFICE USE ONLY PERMIT NO.�
TYPE OF CONSTRUCTION PLAN CHECK NO. ()LI
OCCUPANCY- GROUP Anr\ N PLAN CHECK FEE $
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