HomeMy WebLinkAboutF2022-0425 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
,ease print.3.copies
Associated Building Permit # _ �; Fire Sprinkler Fire Alarm ❑ Fire Misc
1. Project Address( of mailing address) Floor Suite No
Tenant Name I # Units
2. Description of Work
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Use
Valuation $ ( 1l
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
# Stories
❑ New [I Add ❑Alter Demo
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Check Appropriate Box for Applicant/Notification
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3. Owner's Name -Last
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Owner's Address
Owners E-mail Address
City )
State Zip Z Telephone _l "��►-�I — /'�y •-j �i¢ZiG
666�
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F714. Architect/Designer's Name
Last ( First �'--L�—
No.
Architect/Designers Address
Architect/Designer's E-mail Address
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City State Zip Telephoned i
5. Engineer's Name
❑ 9
Last ii,� First
� T'� i � I Lic. No.
Engineers Address
Engineer's E-mail Address
City �' }jd
!, State Zip Telephone a �� I A"v
❑ 6. Contractor's Name Last Lic No. Class
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Contractors Address
Contractors E-mail Address
city
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11 -' Tele hone
L.__—_� State �� Zip p
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHEEK NO.1
OCCUPANCY - GROUP
PLAN CHECK FEE $