HomeMy WebLinkAboutF2014-0552 - Permit Application (2)Worksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Division 1101`$'
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Associated Building Permit#Fires j
Sprinkler j Fire � P __, r'. Fire Misc
1. Project Address (Not mailing
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Tenant Name F_
2. Description of Work
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Extg Sq Ft F777-New/Added Sq Ft Total Sq Ft
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Floor Suite No
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# Units 3
Use
Valuation
# Stories
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[- 3. Owner's Name Last
'First F—
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Owner'sAddress
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Owners E-mail Address
City State
F—� Zip �— Telephoned---
4. Arch itect/Designer's Name Last First Lic. No.
Architect/Designees Address
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Architect/Designers E-mail Address
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FCA Zip Telephone
9!746 (71q)� 310-171?�
5. Engineer's Name Last
First Lic. No. --'
Engineer's Address
Engineer's E-mail Address
City �— _..-_ ---, _ State
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F76. Contractor's Name Last / ��
SpYtr f / 1 {� First Lic. No. Class
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Contractor's Address
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Contractor's E-mail Address
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OFFICE USE ONLY
PERMIT NO. ' 6 Q/ -
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY -GROUP
PLAN CHECK FEE $
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