HomeMy WebLinkAboutF2021-0262 - Permit Application2021— 0262.
E��I0 SS Worksheet for Fire Permit Application
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NeWVcx+ City of Newport Beach -Building Division �
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Associated Building Permit #I d
r Fire Sprinkler j- Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Tenant Name I \11100 �,
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Floor
Suite No
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Use
Extg Sq Ft 11 New/Added Sq Ft [' Total Sq Ft al �a,2 Valuation $
New F; Add FAAlter r Demo
Check Appropriate Box for ApplicanMotification
F 3. Owner's Name Last
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4. Architect/Designer's Name Lastf-
Architectibesigner's Address
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® Owner's E-mail Address
ZIP Telephone
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Architect/Designer's E-mail Address
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City State FT-Zip,9l, 5 Telephone
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. Engineer's Name Last 1111 Firstr
Lie. No.
Engineer's Address VG [a
Engineer's E-mail Address
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City State Zip Telephone
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IXti. Contractor's Name Last FJ��C /
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Contractor's Address 4.3
��j Contractor's E-mail Address
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OFFICE USE ONLY PERMIT NO
16
TYPE OF CONSTRUCTION
OCCUPANCY -GROUP PLAN CHECK NO.
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v f PLAN CHECK FEE $
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