HomeMy WebLinkAboutF2021-0242 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division V ZO 2 (-
X Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not imailing address)
(N
rte gip �uG?i1 f7
C/
Floor No
�g— 910
Tenant Name
Owner's Address
Units
2. Description of Work
City (-_
Use "01
Vi
Zip r~ Telephoned—._+
Add/relocatel7 fire sprinklers
to accommodate new ceiling layout
First ��— Lic. No.I
Architect/Designer's Address
Valuation $ 3,800.00
Extg Sq Ft
New/Added Sq Ft F— Total Sq Ft F_
Zip F Telephone
F- 5. Engineer's Name Last
�
# Stories
0�5
F_ New r Add r
Alter r Demo
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
�
First F_'
Owner's Address
Owner's E-mail Address
City (-_
State F_
Zip r~ Telephoned—._+
F- 4. Arch itect/Designer's Name
Last
First ��— Lic. No.I
Architect/Designer's Address
Architect/Designer's E-mail Address
City I—
State F
Zip F Telephone
F- 5. Engineer's Name Last
�
First r— Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City f
State F_
Zip F_ Telephoned—
1x 6. Contractor's Name Last Parise e� FirstRyan Lic. No. 787301 Class C-16
Contractor's Address
Contractor's E-mail Address
1261 N Lakeview Ave #J-515
City Anaheim
State CA
Zip 92807 Telephone 714-616-0295
OFFICE USE ONLY
26,
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. °
OCCUPANCY- GROUP
PLAN CHECK FEE $