HomeMy WebLinkAboutF2018-0422 - Permit ApplicationWorksheet for Fire Permit Application
of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # A T FJ Fire Sprinkler F_, Fire Alarm
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1. Project Address (Not mailing address) Floor Suite No
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Tenant Name - - _ # Units F
2 Description of Work
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
Valuation $
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Stors
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Check Appropriate Box for Applicant/Notification
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[- 3. Owner's Name Last
i First
Owner's Address
Owner's E-mail Address �` �' 0 �
City
State I ' Zip F Telephone��:.
4. Architect/Designer's Name Last
FirstJ A h Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
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r_`5. Engineer's Name Last �—
First Lic No.
Engineer's Address
Engineer's E-mail Address
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State �.. Zip--, Telephone[ ----'l
F76. Contractor's Name Last F;'/�..v..al- 4�—nrO First— Lic No. W200 Class U
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Contractor's Address
Contractor's E-mail Address
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OFFICE USE ONLY
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PERMIT NO. 0
TYPE OF
OCCUPANCY -GROUP CONSTRUCTION
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PLAN CHECK FEE $
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