HomeMy WebLinkAboutF2021-0461 - Permit ApplicationPrint Form'
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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Associated Building Permit # -ire Sprinkler Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name # Units—':
2. Description of Work
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Use
Extg Sq FtF-71 New/Added Sq Ft Total Sq Ft'
Valuation $ ZB C)
Last j First Lic. No.
# Stories
New F7,Add F–Alter F–Demo
City
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First r:
Owner's Address
Owner's E-mail Address
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I State �— Zip Telephone
r 4. Architect/Designer's Name
Last j First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
', State F, Zip [— Telephoned
[- 5. Engineer's Name Last
First F Lic. No. r 'I
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip [— Telephoned
[- 6. Contractor's Name Last�� First �qn� Lic. No. -7y�136 Class /(P
Contractor's Address
Contractor's E-mail Address
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State ejf Zip GjZ(p�Z Telephone C(elq o0y
OFFICE USE ONLY
�tiA1 �� v J PERMIT NO.
TYPE OF CONSTRUCTION
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PLAN CHECK NO. 24seq °2o2C
OCCUPANCY - GROUP
PLAN CHECK FEE $
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