HomeMy WebLinkAboutF2021-0543 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# Fire Sprinkler
_---- - -- ...__—_....
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
[i Fire Alarm F-1 Fire Misc
Extg Sq Ft i New/Added Sq Ft Total Sq Ft �—
' 7 New [ Add ❑ Alter F- Demo
Check Appropriate Box for Applicant/Notification
(- 3. Owner's Name Last First
Floor
9071n.
1(5PFA5
r—
Suite No
#Units F_
Valuation $
# Stories I U J
Owner's Address Owner's E-mail Address -
I
City State i Zip F_ Telephone
(-' 4. Architect/Designer's Name Last First r Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip Telephone—
(- 6. Engineer's Name Last r2r5 0� _First liA� c- Lic No.
Engin��eer's�s Address Engineer's E-mail Address
//
City State �— Zip Telephone
------- - - -
C 6. Contractor's Name Last KF First St y Lic No. 7�� 1 3 Class
Contractor's Address Contractor's E-mail Address
City N State �— Zip TelephoneF--90 Lj
—
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK NO. ZI,,;I. 02'1
PLAN CHECK FEE $