HomeMy WebLinkAboutF2018-0231 - Permit ApplicationT-- 2 0 lg
Please print 3 copies
Associated Building Permit #
21 Worksheet for Fire Permit Application° e
City of Newport Beach - Building Division
G4FOPN�
ire Sprinkler f— Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name ���` �.�� # Units
2. Description of Work
Owner's E-mail Address -
Use
State F -.
Valuation $
Extg Sq Ft �—I New/Added Sq Ft � Total Sq Ft �
" �— ---
First F Lic. No.
III
# Stories
New r Add r` Alter F_Demo
Architect/Designer's E-mail Address
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address -
City
State F -.
Zip 7 Telephoned ---
F_ 4. Architect/Designer's Name
Last
First F Lic. No.
III
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_
Zip TelephoneF
ci 5. Engineer's Name Last
First, Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip F Telephoned
[! 6. Contractor's Name Last r*�
FirstLic. No1y Class �Lp
Contractor's Address
Contractor's E-mail Add NC
IF -
City �r-�
State C(�-.._.
Zip Telephone'.�t
_
OFFICE USE ONLY
PERMIT NO. rZ91� V"
00m 20
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
•