HomeMy WebLinkAboutF2019-0396 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
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Worksheet for Fire Permit Application p�� _ Re
City of Newport Beach - Bui!ding Division 5� � s
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Fire Sprinkler Fire Alarm jFire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant NameF_ F6
7 #Units
2. Description of Work
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J/3���I�o ed ►`�Ip�S C:�Ctd l��ew �nt�1�t _
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..,-.-.... Valuation $ 52l��
Extg Sq Ft', New/Added Sq Ft Total Sq Ft
New Add `_LLo (�� ` # Stories
I Alter r Dem
Check Appropriate: Box for Applicant/Notification
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( 3. Owner's Name Last
First
Owner's Address
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Owner's E-mail AAs
City _
State
Zip Telephoned
W 4. Arch itectlDesigner's Name
Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City
State
Zip F Telephone
1— 5. Engineer's Name Last
Engineer's Address /
First Lic. No.
Engineer's 0m� A s
City
State
Zip Telephone
3� 6. Contractor's Name Last _
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4F st Lic. No. r0
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Contractor's Address
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Contractor's E-mail Address
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City LPS V l . �^J
State
Zip O g It Telephone oq�Z1:5 /J
OFFICE USE ONLY
TYPE OF CONSTRUCTION
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PERMIT NO.
PLAN CHECK NO. PA
OCCUPANCY - GROUP
D '� V "� PLAN CHECK FEE $ —