HomeMy WebLinkAboutF2019-0029 - Permit ApplicationF'201 q - 001-9
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
— I r Fire Sprinkler U Fire Alarm [7,1 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name # Units F
2. Description of Work
Use! r
Owner's E-mail Address
Extg Sq Ft ii New/Added Sq Ft �--moi Total Sq Ft '
Valuation $ r
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-
-
New (Add f— Alter r Demo
#Stories
Check Appropriate Box for Applicant/Notification
(-; 3. Owner's Name Last
1 First,
Owner's Address
Owner's E-mail Address
City �... -...
StateF
Zip F Telephone
4. Architect/Designer's Name Last
�—
I First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip Telephoned
r 5. Engineer's Name Last
First Lic. No. —I
Engineer's Address
Engineer's E-mail Address
City �-
State—
Zipj Telephone-'--
6. Contractor's Name Last First / Lic. No. r� Class—',
Contractor's Address
Contractor's E-mail ddreSs
/J
City //�. ---
State
Zip Telephon GJ -.33,/7
OFFICE USE ONLY
PERMIT NO.��
TYPE OF CONSTRUCTION
PLAN CHECK NO. 6 •�
OCCUPANCY - GROUP
PLAN CHECK FEE $