HomeMy WebLinkAboutF2021-0414 - Permit ApplicationWorksheet for Fire Permit Application"� Kr
City of Newport Beach - Building Division g
Please print 3 copies i j�n 0 Z 1 D LA M
Associated Building Permit# F, Fire Sprinkler F_ Fire Alarm F Fire Misc
1. Project Address (Not mailing Floor Suite No
address) ll''r
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Tenant Name.iA(/1�(� #Units
2. Descriptions of Work
Owner's E-mail Address
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Use
Extg Sq Ft F— New/Added Sq ---
Ft �, Total Sq Ft F
Valuation $ F1
Last First Lic. No. F
/Vl TOW
# Stories
F New FAdd F_Alter r' Demo
Architect/Designer's E-mail Address
Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last
��`� First.'.
Owner's Address
Owner's E-mail Address
City
State
Zip r Telephone -.
4. Architect/Designer's Name
Last First Lic. No. F
/Vl TOW
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip I Telephone—
(- 5. En meees Name Last
9
_
First �— Lic. No. �
Engineer's Address
Engineer's E-mail Address
City
State �-
Zip F_Telephoner
6. Contractor's Name Last
FirstF Lic. No. O e&ssF
Contractor's Address
Contractor's E-mail Address
City
State �—
Zip Telephoned
OFFICE USE ONLY
PERMIT NO. �02Q
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $