HomeMy WebLinkAboutF2018-0498 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
77 g Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
y._'�f��1�+-�N\ +.T" T. rt S�Jr.+�l2� $`►f�tN�.
Extg Sq Ft �— New/Added Sq Ft Total Sq Ft
g.. New ❑ Add ❑ Alter ❑ Demo ( 43 k
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last Zt h,s o_ First
Owner's Address
City 7 State 1771
Floor
# Units
Use
Valuation $
# Stories
Owner's E-mail Address
Zip F777 Telephonet J
❑ 4. Architect/Designer's Name Last C First F-77-- Lic. No.
Architect/Designer's Address
City —� State F
Architect/Designer's E-mail Address
Zip 7_71 TelephoneF--_t ..
❑ 5. Engineer's Name Last— First Lic. No. 17
Engineer's Address
City —777 State
Engineer's E-mail Address
Zip Telephoned
F16. Contractor's Name Last FEZ
�_ _ First MLic. No. (dU4 Class C_
ContractorsAddress
to. 1
City La,` w`°•� State C�
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Contractor's E-mail Address
(�rurw��: �. c • n _
Zip 5J ()l Telephone-?iq t -s �r
iu A,
PERMIT NO. i l,V u
PLAN CHECK NO. 1t 8 2
CHECK FEE $