HomeMy WebLinkAboutF2018-0413 - Permit ApplicationF q,01/ -b "dWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I—Fire SprinklerFire Alarm. Fire Misc
Floor Suite No
1. Project Address (Not mailing address))
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Tenant Name vac (,� r2 `.- l: $(_ U�. GN �. ®. # Un' -
2. Description of Work
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Use
Extg Sq Ft �! New/Added Sq Ft �-. Total Sq Ft F77777
Valuation $
'� New f - Add r - Alter F_ Demo
# Stories
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Check Appropriate Box for Applicant/Notification
[` 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City
State F- Zip
Telephoned—-
F_ 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City �—
-.: State —'. Zip Telephonel
5. Engineer's Name
LastFm CL A /
First (� t=- 3 Lic. No.
Engineers Address
Engineer's E-mail Address
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City /(�iG
State Zip
���`[._� Telephone `Ts'1_�1 ..3-e137?
F— 6. Contractor's Name
Last K�(L✓l
First 5I iJ Lic. No. Class F6_�,
Contractors Address
Contractor's E-mail Address
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City l-lvn�y'�
State —. Zip
c�a t. (, Telephones ..71, q _ of (,17
OFFICE USE ONLY2
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� PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY -GROUP
PLAN CHECK FEE $