HomeMy WebLinkAboutF2021-0208 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
- --- City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # �(�j L� Z,,6 j'? F_ Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name I
# Units I
2. Description of Work
Use �_..
Valuation $ I
Extg Sq Ft New/Added Sq F_ Ft �Total Sq Ft ZZ�UC &>
F New [7\ Add Alter j Demo # Stories I J
Check Appropriate Box for Applicant/Notification
F 3.Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F_er.
Zip F Telephone
F_ 4. Arch itect/Designer's Name
Last ��� First 5� ,, J1�ic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City
State
Zip Telephone��
F 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
� State F_
Zip Telephone
F76. Contractor's Name Last ll �.� J First Lic. No 6 J Class �0
Contractor's Address
Contractor's E-mail Address
City /��; v�.
State C
Zip G1 Z �`� Telephone 161 _ �` U l — z �I G
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. (t%V) Z-C) C
OCCUPANCY - GROUP
Q
i 1 Z j PLAN CHECK FEE $