Loading...
HomeMy WebLinkAboutF2021-0340 - Permit ApplicationPrint Form Worksheet for Fire Permit Application o o� 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 // 3i�t wz._ a cc�1� Wit Sa 5kuefik) ig6 lSecOe 4yf n141 City State �— Zip F1 Telephone TW_279 5(j OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO. r1 U OCCUPANCY - GROUP n 16 PLAN CHECK FEE $ %I q A 7 17n