HomeMy WebLinkAboutF2019-0606 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler f7j Fire Alarm rl Fire Misc
1. Project Address (Not maaililing address)
00
Floor Suite No
Tenant Name /1�ry�j
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#Units I
City
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2. Description of Work
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City _
State—', Zip f ---�_- , TelephoneF�
Extg Sq Ft
F
New/Added Sq Ft ��� Total Sq Ft
Valuation $
(-1 New (` Add
,Alter F7 Demo
Stories'
Check Appropriate Box for Applicant/Notification
r'i 3. Owner's Name Last i tF
Owner's Address
Owner's E-mail Address
City
State Zip C— Telephone
(— 4. ArchitectIDesigner's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City _
State—', Zip f ---�_- , TelephoneF�
5. Engineer's Name Last
First ( Lic No.
Engineer's Address
Engineer's E-mail Address '
City �— _ _. - Zipr-----�_.. Telephone(-----
6. Contractor's Name Last
—State--,
First I /i-��, Lic. No, Class�—
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Contractor's Address
Contractor's E-mail Addressl[/%�J
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City L O
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State Zip�C ephone JJ� /
OFFICE USE ONLYcj
. I u? c�. W PERMIT NO. Q
TYPE OF CONSTRUCTION
'�tLo 1 31 V PLAN CHECK NO. SO' -5
OCCUPANCY - GROUP
\-) ?, _�-/I Z-- PLAN CHECK FEE $