HomeMy WebLinkAboutF2019-0521 - Permit ApplicationWorksheet for Fire Permit Application (a,
City of Newport Beach - Building Division
Please print 3 copies FF 9-452 J
Associated Building Permit # r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name mrc../4r�"kc,r __-_ �' # Units __...- �L-e�
2. Description of Work
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_ State F i Zip I Telephoned
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Architect/Desi ner's Address
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' �a4g Sq Ft New/Added Sq Ft—',� Total Sq Ft �,
Valuation $ sUQ
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State ( Zip F!: Telephone��,
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New r Add r% Alter r Demo
# Stories
Z St s
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City
_ State F i Zip I Telephoned
F 4. Arch ite 9 First—,' Lic. No. F-
ner's Name LastC\'
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Architect/Desi ner's Address
Architect/Designer's E-mail Address
V Architel
City r—
State ( Zip F!: Telephone��,
F , 5. Engineer's Name
Last First t Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State ZipF -- Telephoned
6. Contractor's Name Last
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Hid yr First Lic. No. Class
Contractor's Address
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Contractor's E-mail Address
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City �h ; n o
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
nLO � –07 ? 7 . �- PLAN CHECK FEE $