HomeMy WebLinkAboutF2019-0518 - Permit Applicationf wa-
Workslheet for Fire Permit. Application
City of Newport Beach - Building Division �{MFOP r
'lease print 3 copies
(—i Fire Sprinkler
Fire Alarm ❑ Fire Misc
Associated Building Permit #
____._—
Floor Suite No
1. Project Address Not mailing address)
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._
❑��
# Units
W1
Bs�
ids/
Tenant Name
2. Description of Work
Use G C�
%
- Valuation $e/ V
NewlAdded Sq Ft
_ J Total Sq Ft
# Stories
Extg Sq Ft
❑ New ❑ Add
[❑ Alter ❑ Demo
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Check Appropriate Box for Appiicarit/Notification
_4i�irst
Last ff�,LE,
Owner's E-mail Address
Owner's Address
State
City
❑ 3. Owner's Name
E]4. Architect/Designer's Name
TelephoneZipUE�lL❑_
Lic. No.�—
First _I
i apt —
LAFchj,tectV/DesIgner`s Address
—� State C❑
City
❑ 5. Engineer's Name
First C._( i/E'
�
Last "��"'� _ --
Engineers Address j
--1
city
State
❑B, Contractor's Name
potLastr_— - -- --.. —
E all Addr
Contractors Address
State �❑
city -- -----
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP -- —
Architect/Designer's E-mail Address I
I
Zip I Telephone
Lic. No.I—=
Engineers E-mail Address I
Zip
Telephone a ' I �fyl
Lic. No. ❑--
Class
Contractor s -m Zip ess
I
�I Telephone __^I
------ ��
PERMIT NO. .. n
PLAN CHECK N0. j
PLAN CHECK FEE $