HomeMy WebLinkAboutF2021-0602 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies n 601
Associated Building Permit # ��, (f Fire Sprinkler [ j Fire Alarm C Fire Misc
1. Project Address (Not mailing
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Tenant Name
2. Description of Work
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Extg Sq Ft C�', New/Added Sq Ft �i Total Sq Ft
j New F_ Add r Alter r Demo
uneCK Appropriate taox for Apphcant/Notitication
Floor Suite No
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# Units
Valuation $ (.� d
# Stories
F- 3. Owner's Name Last
I First
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Owner's Address
Owner's E-mail Address -
StateI
Zip I
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Telephoned--�,
City
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4. Architect/Designer's Name Last ! First Lic. No. � I
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Architect/Designers Address Architect/Designers E-mail Address
City State Zip F Telephoned
r- 5. Engineers Name Last First _ Lic.No. F—
Engineer's Address Engineer's E-mail Address
City I State Zip — Telephoner
EW'Contractor's Name Last First l C� Lic. No. �SZ�I �f Class
Contractor's Address Contractor's E-mail Address
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City v[ ou t r b(n-Q_-..._.- State I `�R Zip �� cJ Telephone(s10)773. 6z
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO. 1 W,�') - vvvv
PLAN CHECK NO.
PLAN CHECK FEE $