HomeMy WebLinkAboutF2016-0652 - Permit ApplicationWorksheet for Fire Permit Application �4�°o°j
City of Newport Beach - Building Division o
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Associated Building Permit# r Fire Sprinkler F_ Fire Alarm rFire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name #Units
2. Description of Work
Use
�—
Extg Sq Ft F— New/Added Sq Ft �—� Total Sq Ft Valuation $
F_ New I— Add # Stories
(— Alter r' Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
! �—
First
Owner's Address
Owners E-mail Address
City
State F Zip TelephoneF
r 4. Architect/Designer's Name
Last First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City 1
State Zip �— Telephoned
F_ 5. Engineer's Name Last
First—
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Engineers Address
Engineers E-mail Address
City
State I — Zip Telephone
7 6. Contractor's Name Last
First— Lic No. Class
Contractor's Address
Contractors E-mail Address
City I
State F_Zip Telephone— �[
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OFFICE USE ONLY
PERMIT NO. 'FZO `(0 - 0 (o j Z
TYPE OF CONSTRUCTION
Q�1 / PLAN CHECK NO.
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OCCUPANCY- GROUP
PLAN CHECK FEE $
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