HomeMy WebLinkAboutF2022-0201 - Permit ApplicationWorksheet for Fire Permit Application U
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit#
ire Sprinkler r7i, Fire Alarm F-! Fire Misc
1. Project Address (Not mailing address)
Tenant Name 1601
2. Description of Work
Ext9 Scl Ft New/Added Scl Ft Total Scl Ft
F7 New F7 Add /PV., Alter F_. Demo
Floor Suite No
# Units
Valuation $ VWN
# Stories
k,neCK Appropriate tiox tor ApplicanVNotlfication
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le V1 V
[7 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City State
Zip
Telephone
F7 4. Architect/Designer's Name Last
First Lic, No.
Arch itect/Des ig ner's Address
------------
Arch itect/Designer's E-mail Address
------------------
city State
r zip
Telephone
F 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State
zip
Telephone
6. Contractor's Name Last�Gh
First Lic. No. Clasl____
Contractor's Address
Contractor's E-mail Address
C, 11rc fl 'V\- Cd
City K(Ju L.-S State
Zi
rnel I Telephone
OFFICE USE ONLY
PERMIT NO. Z)CZ-t
TYPE OF CONSTRUCTION
PLAN CHECK NO. 0L7'202Z-
OCCUPANCY - GROUP DZU7_2 _608
PLAN CHECK FEE $