HomeMy WebLinkAboutF2017-0669 - Permit ApplicationEWPp
Worksfteet -for Fire Permit Application
City of Newport Beach - Building Division 0
Please print 3 copies
Associated Building Permit # _ ❑i Fire Sprinkler Fire Alarm Fire Misc
1, Project Address (Not mailing
Tenant Name
2. Description of Work
Extg Sq Ft C� New/Added Sq Ft Total Sq Ft J
❑ New ❑ Add ❑ Alter ❑ Demo
Check Appropriate Box for Applicant[Notification
Floor Suite No
# Units
Use ._- -------
Valuation $
# Stories I
❑ 3. Owner's Name -
- Last
Owners Address
Owners E-mail Address
City i c
�% )4/ 1/
State �/ Zip 'L(� f Telephone 6
------L - l�
❑4.Architect/Designer'sName
Last First �� Lic.No.l J
Arch itect/Designer's Address
Architect/Designers E-mail Address
City - _
—J State J Zip—� Telephone �l
[I5, Engineer's Name
Last -�'__ I_ First F—K("° 1 Lic.No.�
LLLLLL
Engineer's Address
Engineer's E-mail Address
City L4L�' fij0 .
State C Zip j _A Telephone e/d
❑6. Contractor's Name
Last . "�U tt-r-� Lic No. Class
Contractor's Address
Contractors E-mail Address
City
—J State � � Zip I Telephone
PERMIT NO.
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PLAN CHECK NO"2�
OCCUPANCY - GROUP
PLAN CHECK FEE $