HomeMy WebLinkAboutF2020-0481 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies IFg
Associated Building Permit# �— F-1 Fire Sprinkler (_I Fire Alarm (71 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Owner's Address
Tenant Name% f� . --J e L _ # Units
2. Description of Work
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F_, 4. ArchitectlDesigner's Name
Extg Scl Ft New/Added Scl Ft I Total Scl Ft��i
Valuation $ 6,2"?
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�j New ["'',,: Add f7 Alter �� Demo
# Stories
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Check Appropriate Box for Applicant[Notification
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3. Owner's Name Last i,7-e0j-Vj 4eI First F—
Owner's Address
Owner's E-mail Address
City
I
State—I Zip �— Telephoner— _—
F_, 4. ArchitectlDesigner's Name
Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City—�
State Zip J
5. Engineer's Na--yLast
First Lic. No. F
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Engineer's Address
Engineer's E-mail
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City
State Zip r Telephoner--
(-16. Contractor's Name Last Cj �� —� First �(� Lic. No. �( 3�5��� ! Class C/
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Contractor's Address
Contractor's E-mail Address
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City s o V _.-.
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State
- Zip c1�i Telephone�l�,
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OFFICE USE ONLY
° lSti� PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK No. _ Cs
OCCUPANCY -GROUP
PLAN CHECK FEE $