HomeMy WebLinkAboutF2019-0387 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies X
Associated Building Permit # Fire Sprinkler Fire Alarm
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15,614 ;?Oe 9 o��eW�
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Fire Misc
1. Project Address (Not mailing address)
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Floor
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Suite No
Tenant Name 4Y� .-."'r� _ _._
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City
# Units
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2 Description of Work
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Architect/Designers Address L"y�CMCLI Architect/Designer's E-mail Adc0ass
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Extg Sq Ft F — New/Added Sq Ft-. Total Sq Ft
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Valuation
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Engineer's Address
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Engineer's E-mail Address
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State
Zip �� Telephoner'
Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last
First'
Owner's Address
Owner's E-mail Address
City
State I—
Zip TelephoneF_
F_ 4. Archite t/Designer's Name Last
first Lic. No
Architect/Designers Address L"y�CMCLI Architect/Designer's E-mail Adc0ass
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Zip l��C-.),Z TelephoneFfj IS
En i9�neers Name Last
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First F_�—
Lic. No. �
Engineer's Address
Engineer's E-mail Address
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State
Zip �� Telephoner'
rKContractor'sName Last
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Contractor's Address
Contractor's E-mail Address
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Zip )Tp,, i— Telephone, -')I cj--, (e0^Q�CJ� JO
OFFICE USE ONLY
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612-6-4 PERMIT NO,
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY -GROUP
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PLAN CHECK FEE $