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HomeMy WebLinkAboutF2021-0311 - Permit Application�P r w F�21 41 ,nnt Fgrm; Worksheet for Fire Permit Application Please print 3 copies City of Newport Beach - Building Division o Associated Building Permit # Fire Sprinkler j- Fire Alarm r Fire Misc 1. Project Address (Not mailing address) 3 Floor j'Suite -No— Tenant Name Myr t _ _ 0 #Units (,--_----, 2. Description of Work Extg Sq Ft F� New/Added Sq Ft �-------.-.- Total Sq Ft'.------' r New I - j Add j J Alter F_ Demo Check Appropriate Box for Applicant/Notification Owner's Name Last l rvly e, tel, P � Firstr-_--- ner's Address Owner's E-mail Address Use Valuation $ 2� U O # Stories City r -v \b..G ..._ _.. State L� Zip j�'_-_-._. Telephoned..__ _.. _. J4-Architect/Designer's Name Last Architect/esigners Address E�T? �- _I ,First il)`'y� Lic. No8yZ,8C '1! 11,7? Architect/Designer's E-mail Address w 5�. r cEt.�trtProki��a.C��ol tom% City 17kt I E Zip eyl'�o State SS Telephon w) 3p9 ��4L1 r 6. Engineer's Name Last - First ------ Lic. No. -_- Engineer's Address Engineer's E-mail Address City Statezip Z P Telephoner..__..,-_--- r6. Contractor's Name Last [y UT. First 5_31,tV.i Lic. No.8'ILSS' Class Fc- -14 Contractor's Address 1447-7t L S 1 Contrraactor's E-mail Address .... �t ..chit' COjllel o 4'I. cow. City�i►qr State �' c_ /i Z P %SSS Telephone------------------ `[►cji jQq O(( OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION OCCUPANCY -GROUP PLAN CHECK NO. /1 PLAN CHECK FEE $