HomeMy WebLinkAboutF2018-0680 - Permit ApplicationWorksheet for Fire Permit Application
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City of Newport Beach - Building Division
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Associated Building Permit #I F_ a Sprinkler r Fire Alarm r; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
First,
Tenant Name #Units
Owner's Address
2. Description of Work
— —
CityState
Use
Valuation $
Extg Sq Ft New/Added Sq Ft Total Sq Ft-
-
Architect/Designers Address
# Stories `
New F_ Add f— Alter F— Demo
'
Check Appropriate Box for Applicant/Notification
�— 3. Owner's Name Last
First,
Owner's Address
Owner's E-mail Address
— —
CityState
— —
Zip Telephoner
F— 4. ArchitecUDesigner's Name
Last First F_
Lic. No. F
Architect/Designers Address
Architect/Designer's E-mail Address
City �
'. State F_ Zip F_ TelephoneF
(- 5. Engineer's Name Last
First F
Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F7— Zip FTelephone
[—'6.Contractor's Name Last.
Firsti Lic. No �"�.t�lv:
Class.0—\�,_.
_.. -
Contractors Address
Contractor's E-mail A s
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State C41 _..- Zip ;.o�e3�..-: Telephonel��`1L\'l`
OFFICE USE ONLY
PERMIT NO.
(CIO
TYPE OF CONSTRUCTION
✓JVVV PLANCHECK NO.
V
OCCUPANCY -GROUP
y 12 M/ V PLAN CHECK FEE $
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