HomeMy WebLinkAboutF2018-0114 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# �— �-rG�Sprinkler F_ Fire Alarm r- FireMisc
1. Project Address (Not mailing address) Floor Suite No
Firstl
Tenant Name �.,_ \ #Units F
2. Description of Work
City �,.. -- _._ _ -_
_
Use
Last First Lic.No. F
Valuation $
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft F
--- - - -
State F Zip F TelephoneF
Stories FE
New F_Add F_Alter F_#
Demo
Engineer's Address
Check Appropriate Box for Applicant/Notification
F-,'3. Owner's Name Last
Firstl
Owner's Address
Owner's E-mail Address
City �,.. -- _._ _ -_
State F_ Zip F7_ TelephoneF
F_ 4. Arch itect/Desig ner's Name
Last First Lic.No. F
Architect/Designer's Address
Architect/Designers E-mail Address
City _. _..
State F Zip F TelephoneF
F- 5. Engineer's Name Last
First I Lic. No.
Engineer's Address
Engineer's E-mail Address
i
City -
State F__ Zip F—TelephoneF^
r;6. Contractor's Name Last �( First �-��7 s ic. No. 5� 1� y1Class C ltd
Contractors Address
Contractors E-mail Add
c-,
City
State"i�. Zip ���` Telephone `1�-�-��
OFFICE USE ONLYI
PERMIT NO.
l
1046
TYPE OF CONSTRUCTION
, D��. PLAN CHECK NO. ' `-1=-�-'
OCCUPANCY- GROUP
PLAN CHECK FEE $