HomeMy WebLinkAboutF2020-0045 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division 1�'IyO//(/�1/1/���/\/� (� O UIA6 n
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Please print 3 copies
Associated Building Permit # r
Fire Sprinkler Fi Fire Alarm [J Fire Misc
Floor Suite No
1. Project Address (Not mailing address)
# Units
Tenant Name l ��r
2. Description of Work - —W-�
Use
7
Valuation $
Extg Sq Ft New/
Sq Ft �- !Total Sq Ft
# Stories
(- New Add (_ Alter F7 Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last First
Owner's Address Owner's E-mail Address��_
City State I Zip Telephone
--
rg itect/Designer's Name Lasf Lic, No. `
', First
_ - --
Architect/Designer's Address Architect/Designer's E-mail Address
i
Stat � Zi Telephone
City ' L:'� p��z° �`'"�W
First Lic. No.
--' 5. Engineer's Name Last
Engineer's Address Engineer's E-mail Address
City Telephone
State Zip p
First I Lic. Class��
No. (
(W' 6. Contractor's Name Last I .
Contractor's Address _ Contractor's E-mail Address
- --
City State Zip Telephone[
OFFICE USE ONLY PERMIT N0. 0
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $