HomeMy WebLinkAboutF2021-0172 - Permit ApplicationWorksheei`for Fire Rerttkit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I r Fire Sprinkler r Fire Alarm [— Fire Misc
t. Project Address (Not mailing address) Floor Suite No
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Tenant Name Ae", J p d l PRC y /,�o U # Units �-
2. Description of Work
P�oat-c 6/1a.iSe Spam -,/C— j
Use
State �—
Valuation $ doo
Extg Sq Ft �� New/Added Sq Ft F_ Total Sq Ft
Last First I Lic. No.
F7 New F, Add %L' Alter F-, Demo
# Stories
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last i—
,First
Owner's Address
Owner's E-mail Address
City F
State �—
Zip Telephone
F_ 4. Architect/Designer's Name
Last First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �—
Zip TelephoneF
[` 5. Engineer's Name Last
First Lic. No. F_'
Engineer's Address
Engineer's E-mail Address
City
State
Zip F— Telephone
46. Contractor's Name Last T,,F T" /rc
First Lic. No.y(o Class
Contractor's Address
(,-s d5
Contractor's E-mail Address
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010(0) 'C Nl' dlJ, c`
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City i� �a ~
State (° Nq
zip �1� v? Co Telephone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. rL�
OCCUPANCY- GROUP
PLAN CHECK FEE $
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