HomeMy WebLinkAboutF2024-0042 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application U41,
City of Newport Beach - Building Division
rX Fire Sprinkler F_ Fire Alarm r Fire Misc 410 I E,1,D f
1. Project Address (Not mailing address)
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Tenant Name
2. Description of Work
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
F_ New r Add I- Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
I �'
# Units �—
Use
Valuation $13 aj
# Stories
I- 3. Owner's Name
Last First F
Owner's Address
Owner's E-mail Address
City �
State F_ Zip F TelephoneF—
r 4. Arch itect/Designer's Name
Last Firstlr_ Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State F— Zip F— Telephone
r 5. Engineer's Name
Last / n /S First � Lic. No. �—
v
Engineer's Address
Engineer's E-mail Address
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City F U nn
State �— Zip Ci1G3C Telephone FF-,�2 �- ov �r q
r 6. Contractor's Name Last First S f� Lic. No. g%Classl f
Contractors Address
Contractor's E-mail Address
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f!�.) J6425 cvl rM pooar06av, C.%,
City //VVVr (3eo State �ZGt�� ZiP Cj�(�K� Telephone --r/ 7_ 75) 6
OFFICE USE ONLY
0�1 00 PERMIT NO. - c7�y- OG ��
TYPE OF CONSTRUCTIO4
1
n,,la� 0 �f% PLAN CHECK NO. / G;W �
OCCUPANCY - GROUP
I (1- PLAN CHECK FEE $