HomeMy WebLinkAboutF2021-0584 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division —
Please print 3 copies
Associated Building Permit # -. l Fire Sprinkler F7, Fire Alarm r`i Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
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Floor Suite No
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# Units F7
EMg Sq Ft - t New/Added Sq Ft L.V I- . 7 Total Sq Ft -..�
New [, Add [ Alter F_ Demo
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# Stories FT-]
f3i 3.Owner's Name Last __ First v� eQ V�
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Owner's Address Owner's E-mail Address
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City 1�'Q,W_�VY 1 Sm�j State —, Zip .C\2 V 63Telephone�q�q [4. Architect/Designer's Name Last FirsArchitecUDestigner's E�� Lic. No.I
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Architect/Designer's Address
City —.- State Zip F_ TelephoneF_
[ 5. Engineer's Name Last U — —_ — First A5fR701 Lic. No. P0361�
Engineer's Address Engineer's E-mail Address
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6. Contractor's Name Last �) U First f�V vA pyly Lic. No. �?� �C Class
Contractor's Address Contractors E-mail Address
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OFFICE USE ONLY IZ 3 PERMIT NO.�
TYPE OF CONSTRUCTION S�D� t PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEES ZZZ