HomeMy WebLinkAboutF2021-0051 - Permit Application (2)Worksheet for Fire Permit Application
City of Newport Beach - Building Division _
Please print 3 copies F2,02-1111
I - .50
Associated Building Permit # �— 1 Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name # Units
2. Description of Work
Use (A I
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Extg Sq Ft New/Added Sq Ft �1 Total Sq Ft �7i�{Z� -
Valuation $ Sip
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i New (-J Add I", Alter F7 Demo
#Stories I / f
Check Appropriate Box for Applicant/Notification
Information
[i 3. Owner's Name Last -. _-- -. - First—�!
Owner's Address Owner's E-mail Address
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City � State Fj Zip q�— Telephoner-_--_-�
4. ArchitectlDesigner's Name Las j —t , r j First �' Lic. No. �—
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Architect/Designer's Address Architect/Designees E-mail Address
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City -. - ; StateZip F Telephone
F76. Engineer's Name Last— -. -.-. Firstr Lic. No.
Engineer's Address Engineer's E-mail Address
City �— State�! Zip Telephone -1 1
F-16. Contractor's Name Last First Lic. No. lass
ter; cit
Contractor's Address Contractor's E-mail Address
City State/j ti Zips G Telephone
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO. 6
OCCUPANCY- GROUP p� �� /�yyy PLAN CHECK FEE $