HomeMy WebLinkAboutF2022-0573 - Permit ApplicationSEW FORT
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copiesFire Misc
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Fire arm
Associated Building Permit #
-
Floor Suite No
1. Project Address (Not mailing address)
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# Units �—
Tenant Name �� - - --- — --- -
2. Description of Work
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��� ------------ -- - Valuation $
-- ----
New/Added Sq Ft F
Total Sq Ft
Extg Sq Ft - __-- - �
- - - #Stories I
Alter Demo r
New � Add � _
Check Appropriate Box for Applicant/Notification
Infor-at. - - ',
(— 3. Owner's Name Last First
Owner's E-mail Address
Owner's Address f
State Zip Telephone
City
First Lic. No,
F_ 4. Architect/Designer's Name Last - -
Architect/Designer's E-mail Address
Architect/Designer's Address
State Zip F Telephones
City-
' Lic. No.
9 Last First,
5. Engineer's Name -
Engineer's E-mail Address
Engineer's Address
State F-- Zip �''
Telephone
City _ ..- First -
f Lic. No. �✓���`!�-lass—1
,. • ---- ---�
Contractors Name Last -
-----------
Contractor's E-mail Address
Contractor's Address,�`���
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City - ��- State � (►�''�- Zip Telephone - .�2 �-�
PERMIT NO. J `u
OFFICE USE ONLY LAN CHECK NO. I"1V
TYPE OF CONSTRUCTION PAN CHECK FEE $
OCCUPANCY - GROUP
1