HomeMy WebLinkAboutF2020-0344 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Division Flow_
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Associated Building Permit # �— ! lyi ,_/ Fire Sprinkler r Fire Alarm F71 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last
Tenant Name 17Z,q��,q-vv�,�%��->tic%� # Units
2. Description of Work
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Valuation S0(
Extg Sq Ft New/Added Sq Ft Total Sq Ft r �
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# Stories
F
Check Appropriate Box for Applicant/Notification
jil 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City
State ZipF--�
Telephone—v
F- 4. Arch itect/Designer's
Name Last
j FirstLic No. F�
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State' Zip F Telephoner
F-' 5. Engineer's Name
Last I
First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City
.-. - - State Zip
Telephone—`
X6. Contractor's Name
Last
First j Lic No. FST/ I �i ! Class
Contractor's Address
Contractor's E-mail Address
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'w PERMIT NO. 1
TYPE OF CONSTRUCTION Z 3% .� Z�I
PLAN CHECK NO.
OCCUPANCY - GROUP
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PLAN CHECK FEE $