HomeMy WebLinkAboutF2022-0287 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division g
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Please print 3 copies
Associated Building Permit # AA nn ' Fire Sprinkler [; Fire Alarm r Fire Misc
1 Project Address (Not mailing address) Floor Suite No
Tenant Name or # Units F
2. Description of Work
Extg Sci Ft New/Added Sci Ft L ! Total Sq Ft
KNew F—Add Fi Alter F- Demo
Check Appropriate Box for Applicant/Notification
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Valuation $ $ `
# Stories
F 3. Owner's Name
Last First
Owners Address
)Owners E-mail Address
I
City
State j Zip — Telephone CO/
4. Architect/Designer's Name
Last First Lic. No. �—
— -----_
Architect/Designers Address
____ _
- Architect/Designer's E-mail Address
City
- - _ State F— Zip.. Telephone—
(-5.Engineer's Name
Last LJwah First ��/. Lic.No.�—
Engineer's Address
Engineers E-mail Address
City
State —a Zip Telephone 0 (0 - 5/ y/
r6.Contractor's Name Last y—,ry First ��y�� Lic. No. F_—Class—
C,�ontractor's Address
Contractors E-mail Address
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city s'C'%S/(C,
State L _ Zip 9.Z 50� Telephone(RS/�Z_41/-2p6011
OFFICE USE ONLY_j
Q PERMIT NO. ' 0Z; sq
TYPE OF CONSTRUCTION
— Y �_ PLAN CHECK NO.
\OCCUPANCY -GROUP
PLAN CHECK FEE $
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