HomeMy WebLinkAboutF2018-0126 - Permit ApplicationWorksheet for Fire Permit Application O 50/-20/8
City of Newport Beach - Building Division F.?O/$,01�6
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Associated Building Permit # X w � 7 - l l �; /Fire Sprinkler Fire Alarm F- Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name C--- #Units I
2. Description of Work
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Use
Extg Sq Ft - —' New/Added Sq Ft —; Total Sq Ft [----',
Valuation
C-- -
New Add (!•••••••._ Alter Demo,
# Stories
F_ F_
Check Appropriate Box for Applicant/Notification
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[- 3. Owner's Name Last
First
Owner's Address
Owners E-mail Address
City
'. State
Zip F_ Telephoned
F_ 4. Architect/Designer's Name
Last First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State
Zip r—,Telephone—
1- 5. Engineer's Name Last
First ( Lic No.
Engineers Address
Engineer's E-mail Address
_
City � - - _
.State �'
I
Zip F— Telephoned_i
r 6. Contractor's Name Last yy / ^JQ Z
First PYtGtl� G� Lic. No. F95sg,S5'Class C- I&
Contractors Address
Contractor's E-mail Address
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City F— -
State r
Zip �. Telephone9 2,•'
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
i� r O PLAN CHECK FEE $
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