HomeMy WebLinkAboutF2021-0036 - Permit Application�72p2-1 d o3
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Please print 3 copies
Associated Building Permit#
Lrksheet for Fire Permit Application
w, City of Newport Beach - Building Division
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Fire Sprinkler [i Fire Alarm r{Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Nam e�/
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2. Deisttl—c---rF�i//ption of W�^orkt/�,�t�
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Extg Sq Ft New/Added Sq Ft �����_''�� Total S Ft
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Valuation $
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# Stories I 'L"
Check Appropriate Box for Applicant/Notification
[i 3. Owner's Name
Last ( First
Owner's Address
Owner's E-mail Address
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City
State r— '
,i Zip Telephonej
F 4. Architect/Designer's
Name Last-- First--' Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State— Zip �_----I Telephone
F7 5. Engineer's Name
Last - First ---' Lic. No.I
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Engineer's Address
Engineer's E-mail Address -
City �— -_-
.--- _-_ State--. Zip---- Telephoned--
�i6. Contractor's Name ,
Last 2 First �P aj Lic. No. �p��Class�
Contractor's Address
Ctoontractor's E -mai Address^
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City S',. e�� State I ( Zip p�,.3 Telephone./_Z
OFFICE USE ONLY'
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TYPE OF CONSTRUCTION _ C NO
OCCUPANCY - GROUP
4 PLAN CHECK FEE $
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k� °p CITY OF NEWPORT BEACH
1 tm" COMMUNITY DEVELOPMENT DEPARTMENT
;a An PLAN SUBMITTAL FORM
Print Name �Sp
Signature:
-- — — _.Submitting Plans .
Date: f6ZGfjlZ�a 2,/
Permit Tech:
Phone #: — L�
Email: `'a
PaiftentINLit hod-- — - — -
Payment can be made by credit card via phone at (949) 718-1888.
PAYMENTS MUST BE MADE AFTER 48 HOURS OF SUBMITTAL DUE TO QUARANTINE OF PLANS
Notes: