HomeMy WebLinkAboutF2019-0373 - Permit Application14 l l--%ol q
Fzol9-03-13
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Applicatiow,—�1
City of Newport Beach - Building Divisiop
F,; Fire Sprinkler F-1 Fire Alarm (-I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
F
Tenant Name f - #Units
2. Description of Work
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Use �—
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Extg Sq Ft New/Added SFt Total Sq Ft
Valuation 06)1
( 4. Architect/Designer's Name
# Stories F
F_! New F_ Add r, Alter F_ Demo
Architect/Designer's Address
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
!First F
Owner's Address
Owner's E-mail Address
City,
State
ZipZip Telephone��
( 4. Architect/Designer's Name
Last
IFirst F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City-- --
State �I,
Zip -1 TelephoneF�' ---
F-! 5. Engineer's Name Last
First F— Lijj
c. No.
Engineer's Address
Engineer's E-mail Address
City ._.___.
State (--...
Zip-� Telephoned-_ -...... -...
j-6. Contractor's Name Last
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First Lic. No. F Class`',
Contractor's Address
Contractor's E-mail Address Q�'�j' qz
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._..State Cp'1- ''..
Zip I (O2&7 TelephoneFt(q c7gos/g--
OFFICE USE ONLY
23 2®, PERMIT NO, I ° Q
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
I �•� L� PLAN CHECK FEE $