HomeMy WebLinkAboutF2023-0086 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # (— Fire Sprinkler I J Fire Alarm r Fire Misc
1. Project Address (
t mailing a d e s)
Floor Suite No
Tenant Name
# Units
2. Description of Work
r
---
Extg Sq Ft
—I
! New/Added Sq Ft Total Sq Ft
Valuation $S QQQ
- -
New G Add
[Alter [ Demo
#Stories I V
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last ! First
Owner's Address
Owner's E-mail Address
City
State F Zip F Telephoned_--
I
F_ 4. Architect/Designer's Name Last First F_
Lic. No. �—
Architect/Designees Address
Architect/Designer's E-mail Address
City State F-- Zip F' Telephone—
f_ 5. Engineer's Name
Last First
Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F. Telephoned—,
[! 6. Contractor's Name Last
First— Lic No.
lass
-�,
Contractors Address
Contractor's E-mail Address
City �—
_ - State Zip F Telephoned--,
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK Nn i �s 0—U-4 J7
OCCUPANCY - GROUP
PLAN CHECK FEE $