HomeMy WebLinkAboutF2018-0150 - Permit Application1F
Worksheet for Fire Permit Applicatior
City of Newport Beach - Building Division
Please print 3 copies
Fire Sprinkler F_
Associated Building Permit# j Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Sute No
Units
Tenant Name
2. Description of Work
Use
Owners E-mail Address
city
Extg SqFt New/Added Sq Ft F777-7 Total Sq Ft
Valuation $
Telephone F771
# Stories
JZ�_i N F_ Add f7 Alter F_ Demo
Check Appropriate Box for Applicant/Notification
F7 3. Owner's Name Last
First F777777
Owners Address
Owners E-mail Address
city
State
Zip
Telephone F771
F_ 4. Architect/Designer's Name LastL___
First F - __ Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
state
Zip
F__ TelephoneF77777
F_ 5. Engineer's Name Last
First Lic. N
Engineers Address
Engineer's E-mail Address
City
State
Zip
n
F6. Contractor's Name Last
First Lic. No. Classi-
Contractors Address
Contractors E-mail Address
City
State
Zip
F__ TelephoneF
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO.
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
11M