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HomeMy WebLinkAboutF2023-0133 - Permit ApplicationWorksheet for Fire Permit Application o4�EW�Re Print Form City of Newport Beach - Building Division r Please print 3 copies c�;�oa,,.� Associated Building Permit # J� Fire Sprinkler r— Fire Alarm F- Fire Misc 1. Project Address (Not mailing address) I dui pvewp©vf- Leufz ✓ w Tenant Name Nlei k'lu h 04 at a C) eJ 2. Description of Work N O>L Extg Sq Ft �— New/Added Sq Ft F— Total Sq Ft �— F- New F_ Add F- Alter F_ Demo Check Appropriate Box for Applicant/Notification Floor Suite No 3W,, F— # Units Use Valuation$ # Stories F F 3. Owner's Name Last �— First Owner's Address Owner's E-mail Address City � State F— Zip F_ Telephoned F_ 4. Arch itect(Designer's Name Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City f State Zip [ Telephoned i— 5. Engineer's Name Last First F_ Lic. No. �— Engineer's Address Engineer's E-mail Address City F— Zip �— Telephoned �,/�'—State F— 6. Contractor's Name Last I [µme y �•Vr, syc,65 First Lic. No. � ClassF i "�� / Contractor's Address Contractor's E-mail Address l qq l (.J. lea r ur 43l N 04 qve, City �—tea State F2:F Zip Z70t Telephone NZI 337—%7--i OFFICE USE ONLY �. �y',J PERMIT NO. TSoZ3—Di3') �^^ TYPE OF CONSTRUCTION VV PLAN CHECK NO. G1471-3— �Z�I OCCUPANCY - GROUP PLAN CHECK FEE $