HomeMy WebLinkAboutF2019-0596 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
- r City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # F rt�Sprinkler r Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name I�� (l'/ H ` vl 5 flow AvelV` # Units
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2. Description of Work
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Use
Extg Sq Ft F_New/Added Sq Ft � Total Sq Ft F_
Valuation $ (�
F- 4. Architect/Designer's Name
Last First Lic. No. F—
Architect/Designer's Address
# Stories
New r" Add F_ Alter F_ Demo
City
Check Appropriate Box for Applicant/Notification
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F_ 3. Owner's Name Last
First l
Owner's Address
Owner's E-mail Address
City F
State
Zip � Telephonel�
F- 4. Architect/Designer's Name
Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �—
Zip'— Telephone
(- 5. Engineer's Name Last
L�1 j
First Fi,c S Lic. No. F—
Engineer's Address
Engineer's E-mail Address
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State (fav -v vv
Zip Telephone
F-6.Contractor's Name Last
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First 5� Lic.No. F78i,)3 Class Ji✓
Conntra/cttor's Address
Contractor's E -/mail Address
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State 101-
Zip y y� { b Telephone ',f L/- q07 -7 s�
OFFICE USE ONLY
PERMIT NO. "Y
TYPE OF CONSTRUCTION
PLAN CHECK NO. �{
OCCUPANCY- GROUP
PLAN CHECK FEE $