HomeMy WebLinkAboutF2018-0456 - Permit ApplicationWorl(sheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit
1. Project Address (Not mailing address)
Tenant Name
2 Description of Work
Fire Sprinkler Fire Alarm r Fire Misc
Floor Suite No
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# Units �II�
Use _ J
Extg Sq Ft �� New/Added Sq Ft Total Sq Ft Valuation $��
# Stories 'I fro l
❑ New ❑ Add ❑ Alter ❑ Demo
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name . Last1_l� �/„iA,r7iFirst�J
Owners Address
Owner's E-mail Address
1
city
State Zip Telephone
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4. Architect/Designer's Name
Last First
) Lic. No.�
Architect/Designers Address
Architect/Designers E-mail Address
city
State �� Zip Telephone
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❑ 5. Engineer's Name Last
—`_ I First iVt
Lic. No.
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t
Engineers Address
Engineers E-mail Address
46 /
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city tr' fijo%'. -
Stale C, Zip Telephone
❑6. Contractor's Name Last
_ I Sri F� II tYJvly' f 't f -r/ �— Lic. No.
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Contractors Address
Contractors E-mail Address
City
__ J State Zip Telephone
PERMIT NO.
OFFICE USE ONLY
TYRE OF CONSTRUCTION
PLAN CHECK NO.i7J\b
OCCUPANCY - GROUP
PLAN CHECK FEE $ --