HomeMy WebLinkAboutX2019-4158 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division 7R
Please print 3 copies ; oa
Associated Building Permit ti Fire Sprinkler r Fire Alarm rj Fire Misc
1. Project Address (Not mailing address)
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Tenant Name /�GMA 1263 44,1"_ i
2. Description of Work
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Extg Sq Ft �l New/Added Sq Ft � Total Sq Ft r
A New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
F F
# Units F
Use
Valuation$ ctpp�j06
q Stories
r 3. Owner's Name Last
First
-
Owner's Address
Owner's E-mail Address
City
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State r Zip F_— TelephoneF�
r 4. Architect/Designer's Name Last
�— First F Lic. No.
Architect/Designer's Address
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Architect/Designees E-mail Address
City
State ! Zip Telephone hone
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r' 5. Engineer's Name Last
First— Lic. No. F
Engineers Address
Engineer's E-mail Address
City �
State F— Zip [_ Telephone—i
I 6. Contractor's Name Last �1(�q First1 M/liLic No, F$+al is Class c I t
Contractors Address
Contractor's E-mail Address
114 GAS F/oACS
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OFFICE USE ONLY
II /I (jj ORMIT NO. I
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TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
L of PLAN CHECK NO.
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W PLAN CHECK FEE $
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