HomeMy WebLinkAboutF2021-0434 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division C
r Fire Sprinkler V Fire Alarm r Fire Misc
t. Project Address (Not mailing address)
1
Tenant Name \\ �� +-r_«
2. Description of Work
EMg Sq Ft F_ New/Added Sq Ft F— Total Sq Ft
Floor Suite No
#Units F—
Use
Valuation $ r._
r New F Add r Alter r Demo Z # Stories
Check Appropriate Box for Applicant/Notification
F_ 3. Owners Name
Last First F—
Owner's Address
Owner's E-mail Address
City
State �— Zip F_ Telephone—
r 4. ArchitecUDesigner's
Name Last V�`Qn�V� First s� Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State [_ Zip �— Telephone—
r 5. Engineer's Name
Last First�—Lit. No. F_
Engineer's Address
Engineer's E-mail Address
City
State r— Zip F_ Telephone[—
6. Contractor's Name
lq
Last` ,�C ��` v ` First F_Lic. No.rto Class
j
Contractor's Address
Contractor's E-mail Address
L�
City {{'o�
State I(,,`— Zip Telephone �l�iLfLgf�O�
�rZSJ
OFFICE USE ONLY
PERMIT NO. F2.021- OH3t-(
TYPE OF CONSTRUCTION PLAN CHECK NO. 2 LD 01 I
OCCUPANCY - GROUP
PLAN CHECK FEE $