HomeMy WebLinkAboutF2021-0162 - Permit Applicationt'IiID.rlFsheet'IofFi"re P'ertriit Application
Print Form City of Newport Beach - Building Division tt
Please print 3 copies
Associated Building Permit # Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last � ( Z First v
Tenant Name (a irX. DSCS e #Units �—
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2. Description of Work
G_ " �eaa
Use _
Extg Sq Ft New/Added Sq Ft Total Sq Ft
Valuation $ ;f'CjQ
F-1 New Add kiAlter r Demo
#Stories
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last � ( Z First v
Owner's Address
Owner's E-mail Address
City I
State Zip �'L(p(p'rj Telephoner
4. Architect/Designer's Name Last �— First F_ Lic. No. —'
Architect/Designer's Address
Architect/Designees E-mail Address
City �-
State Zip Telephoner
5. Engineer's Name
Last 'First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip [— Telephoned
6. Contractor's Name Last�k �' First A Lic. No. C�C� �^)� Class �`b
Contractor's Address
Contractor's E-mail Address
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City 7N LIQ of �ernG� State I L j1 ZipGIW�OC� Telephone
OFFICE USE ONLY
PERMIT NO.%�
TYPE OF CONSTRUCTION
�.� PLAN CHECK NO. a�i%2•'iD%�
OCCUPANCY- GROUP�y'
PIAN CHECK FEE $