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HomeMy WebLinkAboutPC2023-0026 - Permit ApplicationPrint Form Please print 3 copies Worksheet for Fire Permit Application Obti City of Newport Beach - Building Division �aa3 _0 Associated Building Permit # [: Fire Sprinkler V,/FireAlarm [_'i Fire Misc 1. Project Address (Not mailing address) Floor Suite No 7 c�Ci l k s� ��x� � C_7 Tenant Name # Units I I — 2. Description of Work FTw�J IXJ 1 rI jk,D AM Use Valuation $ S� Extg Sq Ft New/Added Sq Ft F— Total Sq Ft C ❑ New ❑s/ Add [ Alter ['i Demo # Stories Check Appropriate Box for Applicant/Notification [' 3. Owner's Name Last First Owner's Address Owner's E-mail A ress 7C42 mi - a City QState =ne��o Zip l T2ZQ) ❑ 4. Architect/Designer's Name Last First F77= Lic. No.l I Architect/Designees Address — Architect/Designer's E-mail Ad s City fate Zip 7il elephoneF7:__ ❑ 5. Engineer's Name Last First Lic. No.— Engineer's Address i Engineer's E-mail Addr s City State Zip TelephoneE ❑6.Contractor's Name Lasti First Lic. No. ���/t15 Class t✓=flJ j Contractor's Address Contractor's E-mail Address 70 )J ° "�Im/ Ch ihark j�1(1 S GOn1 City if�f ft- State Zip Telephon wpt! OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION '2 PLAN CHECK NO. FLVZ''/ OCCUPANCY - GROUP PLAN CHECK FEE $