HomeMy WebLinkAboutF2021-0086 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Division V c
21� � Associated Building Permit # 7 F-1 Fire Sprinkler L7 Fire Alarm j—I Fire Misc
1. Project Address (Not mailing
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Tenant Name
2. Description of Work
Extg Sci Ft New/Added Sci Ft Total Sol Ft
New F Add F_ Alter i— Demo
Check Appropriate Box for Applicant/Notification
[i 3. Owner's Name
Owner's Address
City „! State F77
Last ( First
Owner's E-mail Address
Zip Telephone
Floor Suite No
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# Units
Use
Valuation $
# Stories
F_ 4. Architect/Designer's Name Last First F Lic. No. `s_-
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Architect/Designer's Address Architect/Designer's E-mail Address
City State �'. Zip F-_--1 TelephoneF_
[; 5. Engineer's Name Last fjUr First Lic No.
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Engineer's Address
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Cit State
Engineers E-mail Address -
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Zij. ;a .& g. —,' Telephonej
[ 6. Contractor's Name LastIZ- E LL j First � Sr— —; Lic. No. �7& �3j Class
Contractors Address
City -._ State i—I
Contractor's E-mail Address
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Zip �i?L�/L ,.t Telephoner
OFFICE USE ONLY TYZ6 ' r PERMIT NO. 'alo t
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY -GROUP �..� PLAN CHECK FEE $