HomeMy WebLinkAboutF2021-0014 - Permit ApplicationJ
Please print 3 copies
Associated Building Permit #
1. Project Address
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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l� r 00 Fire Sprinkler n Fire Alarm n Fire Misc
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mailing address) Floor Suite No
#UnitsF
EMg Sq Ft �� New/Added Sq Ft Total Sq Ft 7 / 70
(, Add r Alter F7, Demo
Check Appropriate Box for Applicant/Notification
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Valuation$
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3. Owner's Name Last
j First-��
Owner's Address
�1 WEST
Owner's E-mail AddrelvTER GROUP
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City
State
Zip E777 TelephoneF_ --�_---i-�
(- 4. Architect/Designer's Name
Last I First', Lic. No.
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Architect/Designees Address
Architect/Designer's E-mail Address
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city �-
State--
Zip----�I Telephone
5. Engineer's Name Last
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First _ Lic. No.
Engineer's Address
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Engineer's E-mail Address
City �—
State F —
Zip rTelephonef -- ,
F—'6. Contractor's Name Last�py(a�-/
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First f �p+„-� Lic. No. �(GjG,�i(j Class��
Contractor's Address
Contractor's E-mail Address
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State (
Zip, TTelephone idi
OFFICE USE ONLY
PERMIT NO. 'PZo oo\ t i
TYPE OF CONSTRUCTION
PLAN CHECK NO. (200 -7 -C -3 -LA
OCCUPANCY - GROUP
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PLAN CHECK FEE $