HomeMy WebLinkAboutF2020-0270 - Permit ApplicationWorksheet for Fire Permit Application o�Ewgm
City of Newport Beach - Building Division
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Associated Building Permit # ) L� prinkler ( i Fire Alarm r; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name 9 #Units
2. Description of Work
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GPQM tion S
Ext S Ft
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# Stories L .
New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last r
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Owner's Address
Owner's E-mail Address
City State
1 Zip F Telephoned
r 4. Architect/Designer's Name Last
I First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City -. _ State
Zip F � Telephoned—_—
r! 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State
F Zip F Telephoned:
r; . Contractor's Name Last First Lic. No. Class
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Contractor's Address 1` I TNC,
Contractor's E-mail Address
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City { /J _ ,�L f State
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�— Zip �'��rU� Telephone 7�L( f 9 �/s6
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OFFICE ONLY
PERMIT NO. ,
TYPE OF CONSTRUCTION PLAN CHECK NO. 1141tA
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OCCUPANCY - GROUP �1�r D
` PLAN CHECK FEE $
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