HomeMy WebLinkAboutF2021-0305 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not
700 V V �4LQ
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application o"`°"e
City of Newport Beach - Building Division � �
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ire Sprinkler r Fire Alarm r Fire Misc
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Extg Sq Ft F —.. New/Added Sq Ft � 41 q 2 Total Sq Ft
New (— Add F_ Alter j— Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use
Valuation $
# Stories
3. Owner's Name
Last First —
Owner's Address
Owner's E-mail Address
City
State [_ Zip F Telephone
F_4. Architect/Designer's
Name Last s:Ck,d,r First / 4_T3,,,, Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City 'LCinZiwt_ State Zip �z,��iU Telephone '7(y-(o3Q--_V((C
F_ 5. Engineer's Name
Last First— Lic.No.�
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephone)
r 6. Contractor's Name
Last M er FirstFA - Lic. No. g3pgg3 Class
Cjontractto^r''s Address
Contractor's Address
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State CA Zip q�_(p Telephone-ll.�l.-(o3(j-39((p
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
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