HomeMy WebLinkAboutF2020-0013 - Permit ApplicationWorksheet for Fire Permit Application
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City of Newport Beach -Building Division
Please print 3 copies IF?,,,0 , ® n 195
Associated Building Permit # Fire Sprinkler r Fire Alarm F_ Fire Misc
C'9GIC00.N�P
1. Project Address (Not mailing address) Floor Suite No
Last First F
Tenant Name # Units F
2. Description of Work
Use
State F Zip F Telephoned
r 4. Architect/Designees Name Last First F Lic. No. r ,
Architect/Designees Address
Extg Sq Ft New/Added Sq Ft � Total Sq Ft f `I
Valuation $��
-,New n Add Alter Demo
# Stories a—
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last First F
Owner's Address
Owner's E-mail Address
City
State F Zip F Telephoned
r 4. Architect/Designees Name Last First F Lic. No. r ,
Architect/Designees Address
Architect/Designees E-mail Address
City
State Zip Telephoned
F_ 5. Engineer's Name
�i
Last FirstLic. No. F777
Engineer's Address
Engineer's E-mail Address
City
--
State Zip Telephone-
� -- — '
F 6. Contractor's Name Last First Lic. No. Class _
Contractor's Address
Contractor's E-mail Addir'ss
City '� �
State I k � Zip � 3` Telephone \,__
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
�` + �$I1� PLAN CHECK FEE $