HomeMy WebLinkAboutF2021-0265 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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LL Fire Sprinkler r- Fire Alarm Fire Misc
Suite No
1. Projeetct Address (Not mailing address) Floor Suite
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Tenant Name # Units
2. Description of Work
Owner's E-mail Address
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Valuation $/ OIQO-
Extg Sq Ft F_', New/Added Sq Ft F_----.---.-
Total Sq Ft r!
Architect/Designer's Address
Architect/Designer's E-mail Address
# Stories /
C New F_ Add J_ Alter F- Demo
5. Engineer's Name Last � First �
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Check Appropriate Box for Applicant/Notification
(- 3. Owner's Name Last-��'�
First F_
Owner's Address
Owner's E-mail Address
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F- 4. Arch itect/Designer's Name Last
First [ Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip [ Telephoned--
5. Engineer's Name Last � First �
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Engineer's Address
Engineer's E-mail Address
City State F—
Zip F— Telephone-
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F-6.Contractor's Name Last First Lic. No. GLC lass (- -/(�
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Contractor's Address
Contractor's E-mail Address
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City�s
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OFFICE USE ONLY
PERMIT NO. YMr
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP �/��j l� PLAN CHECK FEE $