HomeMy WebLinkAboutF2021-0570 - Permit Application (2)Worksheet for Fire Permit Application
City of Newport Beach - Building Division A
Please print 3 copies
Associated Building Permit# I r Fire Sprinkler Fire Alarm J Fire Misc
1. Project Address (Not mailing address) �FloorSuite No
Tenant Name L — —j al Units
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2. Description of Work eLp S(ti
Owner's E-mail Address
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Extg Sq Ft New/Added Sq Ft Total Sq FtFj
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Add Alter [Demo
New F- I�'
_Use
Valuation $ I
# Stories
Check Appropriate box for Applicant/Notification
3. Owner's Name Last„„M,,-
l First
Owner's Address
Owner's E-mail Address
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City
, State — Zip 1116C& , Telephoner'It T
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4. Architect/Designer's Name Lailt �First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
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City _—_- _-.
State—; Zip Telephoner
S. Engineer's Name Last First F- Lic. No.
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Engineer's Address lul
Engineer's E-mail Address
City — —-------
State—', Zip Telephone—, -- --- —
Contractor's Name Last -i First ��' Lic. No. �— Class
Contractor's Address
Contractor's bTail'Address
City -- -- ---
State .�— Zip-/�Zit�a -' Telephone(O
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
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PLAN CHECK NO.fy0
OCCUPANCY- GROUP
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PLAN CHECK FEE $