HomeMy WebLinkAboutF2014-0614 - Permit Application,z C G l-�vcg
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Applic tat ion
City of Newport B(eaach� Building Division Ig� �� ctJ o
F' mkler C Fire Alarm r Fire MiGsscc�r
1. Project Address (Not mailing address) Floor Suite No
'
# Units
Tenant Name �C��\r.,���•��,_�
:First '..
2. Description of Work
Owner's E-mail Address
Use
�— Telephone
F_ 4. Architect/Designer's Name Last
Valuation $
Extg Sq Ft New/Added Sq Ft F Total Sq Ft
III
�ew
# Stories
[` Add (�•.. Alter F_Demo
First F Lic No. —'
Check Appropriate Box for ApplicantlNotification
3. Owner's Name Last �—
:First '..
Owner's Address
Owner's E-mail Address
..._ ——
City �— State F Zip
�— Telephone
F_ 4. Architect/Designer's Name Last
First —; Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F_ State F_ Zip
-_--- --_ -. ---
F Telephone-
(- 5. Engineer's Name Last
First F Lic No. —'
Engineer's Address
Engineer's E-mail Address
City State F_ Zip
F_____� . Telephone—
F_ ' 6. Contractor's Name Last
��_
FiLic. No. t��Class
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_
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Contractor's Address /
Contractor's E-mail Address
8f
City-�,->��y�"� State Zip`
Telephone,_)\''�`—��.`RJ�j.�
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $