HomeMy WebLinkAboutF2017-0549 - Permit ApplicationWorksheet for Fire Permit Application (F.
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City of Newport Beach - Building Division 1,7 - 6Yql 0
Please print 3 copies `,,,A 6,
Associated Building Permit# Fire SprinklerFire Alarm Fire Misc
2
1. Project Address (Not mailing address) Floor Suite No
W F 771
Tenant Name Units
E__ . .. ............ ...... ..... ----- - ---
2. Description of Work
Use
. . ........
Ext9 Sq Ft F-1 New/Added Sq Ft Total Sq Ft
Valuation $
State Zip Telephone FR�-_____1
Stories
I
M New F Add F-1 Alter F-1 Demo
Architect/Designer's Address
Check Appropriate Box for Applicant/Notification
M 3. Owner's Name
Last Ff irst I
Owners Address
Owners E-mail Address
city L
State Zip Telephone FR�-_____1
F-
__1 4. Architect/Designer's
Last First Lic. No.
Name F_
Architect/Designer's Address
Architect/Designers E-mail Address
City
State F_r Zip Telephone
F F
F, 5. Engineer's Name
Last L IFIP-7 FirstF Lic, No. F-1
Engineer's Address
Engineer's E-mail Address
State ZipF_qTq � Telephone [6771 P# q,
Fj 6. Contractor's Name
Last Lic.No. [777 Cla,sF77
I i
Contractor's Address
Contractor's E-mail Address
I
City r
zip
StateTelephoneF.--.- _-,
OFFICE USE ONLY PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $