HomeMy WebLinkAboutF2019-0268 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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1. Project Address (Not mailing address) Floor Suite No
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Tenant Name\_ V`_b __. _-........� #Units I
2. Description of Work
Owner's Address
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Use
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
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Valuation $
New r Add F_ Alter Demo
# Stories
Check Appropriate Box for Applicant/Notification
(- 3. Owner's Name Last �—
First
Owner's Address
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Owner's E-mail Address
City F
State
Zip F —.... Telephone
4. Arch itecUDesigner's Name Last
I First
Lic. No. (---,
Architect/Designer's Address
Architect/Designer's E-mail Address
City --. -.
State �
Zip r---._-- Telephone
5. Engineer's Name Last
---
--
---___
First F_
Lic. No.
Engineer's Address
Engineer's E-mail Address
City _ _
State F—
Zip F— Telephone
6. Contractor's Name LastFirstLic. No. l Class
Contractor's Address
Contractor's E-mail Address
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City -,-...,..
State f}
Zip 0 31 Telephone
OFFICE USE ONLY
PERMIT NO'.
TYPE OF CONSTRUCTION
PLAN CHECK NO. i'ih
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OCCUPANCY - GROUP
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PLAN CHECK FEE $
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