HomeMy WebLinkAboutF2020-0412 - Permit ApplicationWorksheet for Fire Permit Application o�� �°°"s
City of Newport Beach - Building Division
Please print 3 copies +c�.o•N'
Associated Building Permit # Fire Sprinkler ❑ Fire Alarm r; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
�1 p
Tenant Name # Units �-
2. Description of Work
Use
NFP-Ik 1�_a__syfE�h_ � -
- - - -_ .
Valuation $ 16
EMg Sq Ft New/Added Sq Ft F_ !Total Sq Ft
3 l # Stories
F:New F_ Add Alter r. Demo �� �� F
Check Appropriate Box for Applicant/Notifica
r; 3. Owner's Name
Last First
f _
Owner's Address
Owner's E-mail Address
city Cid'
�I Zip State F Telephone
F_4. Architect/Designer's
Name Last First Lic No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City -
State C_QS'-rR TelephoneF
F 5. Engineer's Name
Last First l Lic. No. f
//-�AAAA/� ��1�
VIA CAT
Engineer's Address
E RtM�P —
r 6
City �
State I Zip F—i' Telephoned'.
j i6.Contractor's Name
Last 1c� First �•��� Lic.No.F Class GC
Contractor's Address
Contractors E-mail Address ��Lf2Da�
V, SA --
try ✓ NrS- Sy rw1.c.�
City -. L , V' 4L_ , _
- State I C rT Zip F16 d 31- , Telephone Alt + / , S j
OFFICE USE ONLY
PERMIT NO. • ��
�W14-0100
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP
I PLAN CHECK FEE $