HomeMy WebLinkAboutF2018-0324 - Permit Application (3)Print Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
33Z10 r�
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler FW Fire Alarm r Fire Misc
Extg Sq Ft r New/Added Sq Ft
I. ' New F_ Add F_ Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Total Sq Ft
U
Floor Suite No
# Units
Use
Valuation $
# Stories
r" 3. Owner's Name Last
First I
Owner's Address
Owner's E-mail Address
City State
Zip F Telephoner—
s 4. Architect/Designer's Name Last
—
FirstF_ Lic.No.F
Architect/Designer's Address
Architect/Designees E-mail Address
City State
r--- Zip F_ Telephone[—
r- 5. Engineer's Name Last etVa First 6(;VA,7ZCP d Lic. No. FSuzy
Engineer's/
Engineer's E-mail Address
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City �/tx< State
- Zip I
l Telephone /Yi 7 z-�q�G
F_ 6. Contractor's Name Last -
GJJ (f First F - - Lic. No. g �Qz��Class F�/6
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Contractors Address
Contractor's E-mail Address
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City �� State
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Zip !0 Telephone7�y)'3sZ 61q[dl✓
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OFFICE USE ONLY
PERMIT NO. i- oZ 01 R - O3,L ri-
TYPE OF CONSTRUCTION
PLAN CHECK NO. i ?D 2 - Z 01 S
OCCUPANCY - GROUP
PLAN CHECK FEE $