HomeMy WebLinkAboutX2021-1590 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies 0
Associated Building Permit # [-j Fire Sprinkler Fire Alarm (-j Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Units
Tenant Name # �-
Extg Sq Ft New/Added Sq Ft _ Total Sq Ft i
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Check Appropriate Box for Applicant/Notification10
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Valuation $ E
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3. Owner's Name Last 'x(Z i r� 60 4 First �—
Owner's Address Owner's E-mail Address
Ciry J P0)ZrState r Zip ' 0 Telephone
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(- 4. Architect/Designer's Name Last I First Lic. No.
Architect/Designees Address Architect/Designees E-mail Address
City i State Zip Telephone
r1 5. Engineer's Name Last Lipp,First f Lic. No.
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Engineer's Address Engineer's E-mail Address
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city_ "1 _ -bG - - State- Zip Telephone.._.�(/���%f'
(` 6. Contractor's Name Last lJj ' )K&XH j st I Lic. No. Class
Contractor's Address Contractor's E-mail Address
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City State F-` Zipy; Telephone�
OFFICE USE ONLY PERMIT NO.
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TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP PLAN CHECK FEE $