HomeMy WebLinkAboutF2021-0371 - Permit Application1�al IN
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Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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Fire Sprinkler [7 Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name L6. e(..._ � .i[ _ 2-0 p # Units
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2. Description of Work
Use
Valuation $ 4 f� I
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E#g Sq Ft I New/Added Sq Ft Total Sq Ft —�
New F_ Add ry/Alter F Demo
# Stories
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Check Appropriate Box for Applicant/Notification
F_1 3. Owner's Name Last � -� ��e Orst F
Owner's Address Owner's E-mail Address
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City � State Zi Telephone[-
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(` 4. Arch itecUDesigner's Name Last1 First Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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City- -_ State Zip Telephone
5. Engineer's Name Last F3;) "Z7 Mtl� OFirst / �Cc'L1
Lic. No. 6 /
Engineer's Address Engineer's E-mail Address
City State - Zip �! Telephoned—�
(i'6. Contractor's Name LastI First Lic. No. 1✓`lass
Contractor's Address Contractor's E-mail Address
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city LAW
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OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP (n/I it rl o (, PLAN CHECK FEE $
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