HomeMy WebLinkAboutF2021-0637 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # —�
-- i (-I Fire SprinWer 36 Fire Alarm I I Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
Extg Sol Ft r New/Added Sq Ft F Total Sq Ft F
�i New F_ Add [7 Alter j-: Demo
Floor
Suite No
# Units
Use G
_ I
Valuation $ Zf16
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# Stories j
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3. Owner's Name Last �ji t Cp� First
Owner's Address
Owner's E-mail Address
--
�o°Rf Grr — - - -
City i�o2� �j C{� State Zip q 61 0 Telephone
j-4. Architect/Designees Name Last First—; Lir- '
-- -
ArchitecVDesigners Address Architect/Designees E-mail Address
City State F Zip Telephoned—
[` 5. Engineer's Name Last Y First ��—�—�y— �����
Engineer's Address - Engineer's E-mail Address
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Gcityrl�j- t>-/-DVLn State Zip - Telephone!
F6. Contractor's Name Last Jfj� �g eM� st Lic No. Class
Contractor's Address Contractor's E-mail Address
City
i State �- Zip (_----- Telephoned -
OFFICE USE ONLY PERMIT NO. _EZP_�QA - 6)1
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $