HomeMy WebLinkAboutF2021-0340 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
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City of Newport Beach - Building Division g
Please print 3 copies Gaps
Associated Building Permit # r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
159 l MO N P-o v) a 11ve tJ-'e �etll)Ibn+ P-*D, uA 9 960 F I
Tenant Name /-'.r\o1UIJ o-t.L
2. Description of Work
Extg Sq Ft �— New/Added Sq Ft ;�i i<O Total Sq Ft I -.;i,\ U
j New j- Add r Alter F_ Demo
" lw�n ^PPrupna[e mox ror Applicant/Notification
#Units F
Use
Valuation $ 16 tP)1
# Stories F
3.Owner's Name
Last
First F—
Owner's Address
Owner's E-mail Address
City
State F_ Zip
�— Telephone—
r 4. Architect/Designer's
Name Last
First F— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip Telephone—
r 5. Engineer's Name
Last F
First F_ Lic. No.
Engineers Address
Engineer's E-mail Address
City
State F— Zip
F— TelephoneF—
�6. Contractor's Name
Last sk�t Ci- �� 11
First 10 Lic. No. 78,2-79`1 L'
Class ,O
1
Contractor's Address
Contractor's E-mail Address
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City
State �— Zip
F1 Telephone TW_279 5(j
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
r1
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OCCUPANCY - GROUP
n 16
PLAN CHECK FEE $
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