HomeMy WebLinkAboutF2022-0045 - Permit ApplicationWorksheet for Fire Permit Application ��"
Print Form � �
City of Newport Beach -Building Division � g
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Associated Building Permit # J� & r _ '�-1 c r; Fire Sprinkler r Fire Alarm !![�'! FirevvM`iisc
1. Project Address (Not mailing address) l Floor Suite No
60
Tenant Name N � w �b Ys # Units
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2. Description of Work
(�� Use
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L-17:;- A -
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F �I Valuatio Sa �J
Extg Sq Ft New/Added Sq Ft Total Sq Ft
# Stories �7
❑ New F- Add n Alter F1 Demo -
Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last —
-! First
Owner's Address
Owner's E-mail Address
City State
Zip F J Telephoned
ri 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City F State
Zip 7 TelephoneF7777
F-_ Engineer's Name Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State I
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Zip Telephoned'
['i 6. Contractor's Name Last - l First Lic. No. �j j' Class L jrJ
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Contractor's Address 5-')ut fty IL� 5• i iJL
Contractor's E-mail Address
City State
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Zip 1Tele hone -
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OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NO. fZ0--L Z - 0C)q
PLAN CHECK NO. 2ZZ--S - zoz
PLAN CHECK FEE $