HomeMy WebLinkAboutF2020-0107 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division o
Please print 3 copies one
Associated Building Permit # Fire Sprinkler [ Fire Alarm f7j Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
Tenant Name – _— j
# Units
2 Description of Work
Use
Valuation $ F J
E#g Sq Ft � New/Added Sq Ft �I Total Sq Ft
New r—Add F_ Alter FDemo
# Stories
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Check Appropriate Box for Applicant/Notification
F, 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
-___._ .. __.__._.... _.:__...--_ .__._..._____._i
City �— State F Zip r-- Telephone��,',
4. Arch itecUDesigner's Name Last I FirstF— Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
city � _ . State �—I Zip F_11 Telephone
Engineer's Name Last r First——! Lic. No,
Engineer's Address Engineer's E-mail Address
City State F Zip ---i Telephone��
F76. Contractor's Name LastT yFirst ��t'� Lic No. [��GSj Class Cj[C/o
-
Contractor's Address / Contractor's E-mail Address /�–�
_ L'.'(%ll.._ __..._-- t l�tVp1 eeis,din-f'ifa5'p!y �vo,.r
city �t) �W State Zip
OFFICE USE ONLY 2 ' PERMIT NO. �n�r ' Q I n-1
TYPE OF CONSTRUCTION v— PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $
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