HomeMy WebLinkAboutF2018-0489 - Permit ApplicationWorksheet for Fire Permit Application Q�EW�Re
Print Form—]PP
City of Newport Beach -Building Division
Please print 3 copies D. 10 ` ,_ 0 ` `(�
Associated Building Permit #
Fire Sprinkler ❑ Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name - — # Units
2. Description of Work
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4. Architect/Designer's Name Last -�/d
First P Lic. No. L
Architect/Designer's Address
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Extg Sq Ft � New/Added Sq Ft �J Total Sq Ft
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Valuation $ �/
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# Stories [27
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last1 _7 ®`e� \
-- First \,=�-- —
Owner's Address
Owner's E-mail Address
City l___I State _— Zip
TelephoneL_j
4. Architect/Designer's Name Last -�/d
First P Lic. No. L
Architect/Designer's Address
Architect/Designer's E-mail Address
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IjJState Zip/
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FtQ Telephone iL)3LL-4/[
5. Engineer's Name Last
First F7-7 Lic. No.
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Engineer's Address
Engineer's E-mail Address
City _ I State �— Zip
C Telephone
F-77
❑ 6. Contractor's Name Last �a(r 2 First �� Lic. No.l� Z J Class��
Contractor's^ Address
Contractor's E-mail Address
City � �_ ` �� State C'� Zip
��f Telephone
OFFICE USEONLYPERMIT
NO.
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP > 47 —
PLAN CHECK NO.
�/ PLAN CHECK
FEE $
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