HomeMy WebLinkAboutF2023-0018 - Permit Application07 3_c)o g Worksheet for Fire Permit Application oF� °Rm
City of Newport Beach - Building Division 6 _�
Please print 3 copies ° G-p0.
Associated Building Permit �— j7 Fire Sprinkler j_ Fire Alarm F Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name lCA
#Units I
2. Description of Work'
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Extg Sq Ft New/Added Sq Ft �—' Total Sq Ft �— Valuation $
�i New Add F_- Alter F_ Demo # Stories
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F7 3. Owner's Name
Last Firstr—
i
Owner's Address
-
Owner's E-mail Address
City -- _
State F ZiP F— Telephoner - -
4. Architect/Designer's Name Last i First F_ Lic. No. �—
Architect/Designer's Address
Architect/Designers E-mail Address
City -. --._ -..._.
State I -- -" Zip F Telephone r
r 5. Engineer's Name
Last t Firs
--- _ _ Lic No. �...,...
Engineer's Address
III _
Engineers E-mail Address
City
State �— Zip F_ Telephoned--
$6. Contractor's Name Last
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Contractor's Address
--
Contractor's E-mail Address
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-- State ��., Zip ---1. 1g Telephon 7j 1. �� a35
OFFICE USE ONLY
PERMIT NO. FZ0Z,
TYPE OF CONSTRUCTION
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PLAN CHECK N0. f KUV_ OOb2
OCCUPANCY - GROUP
PLAN CHECK FEE $
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