HomeMy WebLinkAboutF2018-0612 - Permit ApplicationPrint For Worksheet for Fire Permit Application
City of Newport Beach - Building Division a
Please print 3 copies / L-,) p
Associated Building Permit # Fire Sprinkler ❑ Fire Alarm ❑ Fir-e�Miisc
1. Project Address (Not address) Floor Suite No
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Tenant Name ��� L i� ��� i� # Units
2. Description of Work
State F77 Zip C— Telephone
❑ 4. Architect/Designer's Name Last F- First E77-7 Lic. No.
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Architect/Designer's E-mail Address
Use
State F Zip � Telephoned
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❑ 5. Engineer's Name Last MCC / CC 21 L/_First vU �^ S Lic. No. J
Valuation $ _ �� �?-'
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Extg Sq Ft �J New/Added Sq Ft E7777 Total Sq Ft C�
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# Stories
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last L� First S
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Owner's Address
Owner's E-mail Address
City
State F77 Zip C— Telephone
❑ 4. Architect/Designer's Name Last F- First E77-7 Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City-�
State F Zip � Telephoned
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❑ 5. Engineer's Name Last MCC / CC 21 L/_First vU �^ S Lic. No. J
Engineer's Address
Engineer's E-mail Address
City - CJ ti (s ��
StateZip [o�d Telephone �� _ ars 3_ q -9-7
❑ 6. Contractor's Name Last iCLLLLj 7771 First S F Lic. No.FAQ Class
Contractor's Address
Contractor's E-mail Address
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City State r�r✓�__ _, State Zi P��cr Tele hone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
' O l l \01 PLAN CHECK NO.
PLAN CHECK FEE $
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