HomeMy WebLinkAboutF2018-0613 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Divisi (l�^ q cow' a
Please print 3 copies � n,2 yr
Associated Building Permit# ire Sprinkler [; Fireft, Fire Misc q_
1. Project Address (Not mailing address) Floor Suite No
# Units
Tenant Name 1
2. D cription of Work
Owners E-mail Address
Use
e
-
Valuation $��
Lxtg Sq Ft New/Added Sq Ft F Total Sq Ft F_
!
ArchitecUDesigners Address
# Stories
III
New )—••_: Add F_ Alter (—•:• Demo
City �.. _. State
Check Appropriate Box for ApplicantlNotification
F_ 3. Owner's Name Last �
First
Owner's Address -
Owners E-mail Address
City ! State
Zip Telephoned,
4. Arch itect/Designer's Name Last F
First F Lic. No. F
ArchitecUDesigners Address
Architect/Designer's E-mail Address
City �.. _. State
F_,
Zip [— Telephoned --
r 5. Engineer's Name Last
First Lic No. F—'
Engineer's Address
Engineer's E-mail Address
City _. State
F
Zip F Telephoned_
f76. Contractor's Name Last
First Lic. No. Q � Class
Contractor's Address)
Contractor's E-mail Address
zzt
City State
Zip ��\ Telephonedr
OFFICE USE ONLY
PERMIT NO. 1
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $