HomeMy WebLinkAboutF2021-0230 - Permit ApplicationPrint Form
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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
�wIGI jC1C1 Fire Sprinkler ,F\FireAllarm Fire Misc
1. Project Address (Not mailing address) FloorSuite No
`a37 F_ F_ .-.
I a 39, l a L- l W I nS10LX> L _.-___ ane
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Tenant Name #Units FS
2. Description of Work
Owner's E-mail Address
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Use P,$1Cf"P/1fia.....G(yrlyS
Fiore fel rm _.51_)r1nl,lt'r l'nanrlar/?�
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City !\1EW�OY7 &G.L%1-....
Extg Sq Ft '7�aL/ New/Added Sq Ft 7/ 4/ Total Sq Ft 70-,/
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Valuation $��� --
rj( New FW Add [ Alter F- Demo
# Stories
Check Appropriate Box for Applicant/Notification
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F_ 3. Owner's Name Last
p8 fr/e_r
First
Owner's Address
Owner's E-mail Address
Sq,5 DbVe `87L .
ret �Pr @ in Fra c or�
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City !\1EW�OY7 &G.L%1-....
State C'p-Zip
gabb.6 Telephone j, 7'j`j. 8 {(Oq
4. Architect/Designer's Name
Last %U First I---- —' Lic. No. f ----
Architect/Designer's Address
Architect/Designer's E-mail Address
City __..
State �.-- Zip (-_ Telephone-----.--
[ 5. Engineer's Name Last
A
First I -----
Lic No.
Engineer's Address
Engineer's E-mail Address
City
State [--Zip
Telephone r—..._—_._— _..
F- 6. Contractor's Name Last ?o7WS
First 7' Lic. No. ClassCI � o
Contractor's Address
Contractor's E-mail Address
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city
State CA - Zip
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-//` Telephone rte' d7O (i Ss
OFFICE USE ONLY
PERMIT NO. i
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
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v�� �j PLAN CHECK FEE $