HomeMy WebLinkAboutF2023-0493 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
t. Project Address (Not mailing
Worksheet for Fire Permit Application U40--
City of Newport Beach -Building Division
Fire Sprinkler r Fire Alarm r Fire Misc
Tenant Name I *0
2. Description of Work
t�locu {f (5') VA'nxler-
Extg Sq Ft 3�- New/Added Sq Ft �— Total Sq Ft 3, j y
r New r- Add f�' Alter j— Demo
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last
Owner's Address
First
Owner's E-mail Address
Floor Suite No
F7 - 9
# Units I —
Use 1110e2Aant 'te
Valuation $
#Stories F
City I State F— Zip [_ Telephonef�
f 4. Architect/Designer's Name Last
First F� Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I State F_ Zip [� Telephone[�
I— 5. Engineer's Name Last I First F —
Lic. No. r--
Engineer's Address Engineer's E-mail Address
City State F_ Zip [_ Telephone[�
I— 6. Contractor's Name Last Cm�pd First[�?� -S Cj --
f pl , e / — Lic No. � t/a Class rk
Contractor's Address Contractors E-mail Address
C�c Fi (��110 tic �,®/1LQ avr Co2� I'1 � ice.
S!-
City �
/Ul.du,oll C,'�y State C/tj Zip qI �G 5 5 Telephone ZrGI ,7ct(
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $
a