HomeMy WebLinkAboutF2022-0218 - Permit ApplicationWorksheet for Fire Permit Application
rte/ City of Newport Beach - Building Division
Please print 3 copies RDI • -Dag
Associated Building Permit # �4 ,�, Uj G� F-1FireSprinkler Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
A1% 11�5� �r�z F _-���� _r� [� _ C-
Tenant Name - „- - - - _ _ -- -_ #Units I
2. Description of Work
City C - � State L I
Fire - S rtnkter motgi
[i 4. Architect/Designer's Name Last�— _ - — First Lic. No. �—'
Architect/Designer's Address
EMg Sq Ft J New/Added Sq Ft Total Sq Ft
Valuation $ f 7
b--� J
City �_ '.... State—;
Zip Telephoned
New [Add ❑Alter Demo
# Stories
_J
C 5. Engineer's Name Last aLaC
First �g� Lic. No. L
i
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last �— _
First—;
Owner's Address
Owner's E-mail Address
City C - � State L I
ZipF—', Telephone- �
[i 4. Architect/Designer's Name Last�— _ - — First Lic. No. �—'
Architect/Designer's Address
Archrect/Designer's E-mail Address
City �_ '.... State—;
Zip Telephoned
_
C 5. Engineer's Name Last aLaC
First �g� Lic. No. L
i
Engineer's Address
Engineer's E-mail Address
City ! - State 6A
Zip-/�� Telephone
C6. Contractor's Name Last FirstF Lic. No. 7t7 t Class C�Q
Contractor's Address
Contractor's E-mail Address
City - BYE..._. State �(} ..-
Zip (U_ Telephone Cr�� o�7V !J'
OFFICE USE ONLY
PERMIT NO. F Z4VL ' UZ
TYPE OF CONSTRUCTION
PLAN CHECK NO. I ZCS(TL
OCCUPANCY - GROUP
C)2 -Sq PLAN CHECK FEE $