HomeMy WebLinkAboutF2024-0112 - Permit ApplicationPrint Form UN
Worksheet for Fire Permit Applicationyr --City of Newport Beach -Building Division
Please print 3 copies ,,II
Associated Building Permit# F_ Fire Sprinkler Fire Alarm Fire
1. Project Address (Not mailing address)
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Tenant Name
2. Description of Work
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Extg Sq Ft F
New/Added Sq Ft
Total Sq Ft
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Add r
Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor
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Suite No
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# Units
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Valuation $ I 1 wL
# Stories l�
r 3. Owner's Name Last W 1 �hM.CnM First
Owner's Address
Owner's E-mail Address
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city State I ( `
Zip q " i I TelephoneF_
r. 4. Architect/Designer's Name Last F First I Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City �— State F_
Zip F— Telephoned—®
1— 5. Engineer's Name Last (
First F— Lic No. q__e 9j
Engineers Address
Engineer's E-mail Address
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Zip AI I %' Telephone I f0 q , y - l I I>
r— 6. Contractor's Name Last
First I! Lic. No. �- Classl
Contractor's Address
Contractor's E-mail Address
City State F—
Zip F_ TelephoneF_
OFFICE USE ONLY
PERMIT NO. TZ24 •011Z
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $