HomeMy WebLinkAboutF2018-0281 - Permit ApplicationWorksheet for Fire Permit Applicatiorr
Building Division
Please print 3 copies City of Newport Beach -
Associated Building Permit# Fire Sprinkler [7, Fire Alarm F-, Fire Misc
01 910-1
rM
1. Project Address (Not mailing address) Floor Suite No
Last FirstF-
Tenant Name UnitsF
III
2. Description of Work
Use F_
Extg Sq Ft F7777 New/Added Sq Ft Total So Ft
Valuation $
Architect/Designer's E-mail Address
# Stories
New Add Alter Demo
5. Engineer's Name
Check Appropriate Box for Applicant/Notification
F7 3. Owner's Name
Last FirstF-
Owner's Address
Owners E-mail Address
City StateF_Zip Telephone c4F F
First Lic. No.
r- 4. Arch itectlDesigner's Name Lasti- F F77
Architect/Designers Address
Architect/Designer's E-mail Address
City
State F zip F Telephone I
5. Engineer's Name
Last no-Al-ce FirstFM-Q-- -- )(
- ------ Lic. No.F
Engineers Address
Engineers E-mail Address
I Wes r
V H K, F _rAR K � 0i y4sl VC1, (I"
city
State FY_ zip1___q)T_0/7 TelephoneF-111- --&66 —gfs
o
F/ca 55
F-6. Contractor's Name Lastj Lic. No. --n-,
1,
Contractor's Address
Contractors E-mail Address
PV rVE I 1A OKI
City F_N04AIM VA
Fq!B C Telephonel
State FC Zip 666 -*So
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. Q q
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE
I