HomeMy WebLinkAboutF2018-0672 - Permit ApplicationF T-0 l5 -0&7 Z Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # F_j Fire Sprinkler [! Fire Alarm F7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last
# Units I
Tenant NameNk
o Ccs- t
2. Description of Work
Use
City �—
State F
Valuation
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
--
New � Add Alter r Demo
# Stories
Architect/Designer's E-mail Address
City
Check Appropriate Box for Applicant/Notification
F, 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City �—
State F
Zip F_— Telephone
F_ 4. Architect/Designer's Name Last
i First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State—
Zip Telephoned
F_ 5. Engineer's Name
Last
First Lic. No. F
III
Engineer's Address
Engineer',. E-mail Address
-�,-
; .
City
State �—
---
Zip . Telephone�—
1-76. Contractor's Name
Last (� _ First Lic. No. Class
Contractor's Address
CoCntract�or's E-mail Ad
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City
State
Zip Telephone --��_
_ -_
PERMIT NO. ¢^ =
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
f
N�� ' (� -
�'\r, PLAN CHECK NO.
L -` PLAN CHECK FEE $
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