HomeMy WebLinkAboutF2018-0599 - Permit Application (3)Worksheet for Fire Permit Application Please print 3 copies SEW
City of Newport Beach - Building Division (� j�
Associated Building Permit #
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F Fire Sprinkler r` Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor_ Suite No
Tenant Name
#Units
2. Description of Work
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Extg Sq Ft New/Added Sq Ft Valuation $ F —
Total Sq Ft �--
J- New ( Add r Alter F_
j- Demo #Stories
Check Appropriate Box for Applicant/Notification
r— 3. Owner's Name Last
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Owner's Address - -
Owners E-mail Address
City 1 State Zipj
- � l Telephoned----
(— 4. ArchitecUDesigner's Name Last
First Lic. No. Architect/Designers Address - -
!Architect/Designees E-mail Address
City State
i - Zip I --- Telephone
F 5. Engineer's Name Last
First I
Engineer's Address - Lic No.
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Engineer's E-mail Address
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City i - (�— -
State I Zip �— Telephoned---
(- 6. Contractor's Name Last ��—
��7Sei1 First. Lic No. r-- Class!
Contractors Address ))) 1 �' �-�3i
Cant rac or's E-mail Addr ss
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e- ✓tee o�C(.0 State Zip ? 1p O
1 + C/� (�Lpto3 Telephone- 3 -545-
OFFICE USE ONLY
TYPE OF CONSTRUCTION PERMITNO. � lV,
OCCUPANCY -GROUP PLAN CHECK NO.
PLAN CHECK FEE $