HomeMy WebLinkAboutF2021-0438 - Permit ApplicationWorksheet for Fire Permit Ap IC '/j'��
City of Newport Beach - Building Divi n V V v , o
Please print 3 copies �<;.o„�•�
Associated Building Permit# 1=1 Fire Sprinkler rj Fire Alarm rj Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name
(�Ap�M+"'�( #Units
f!
2. Description of Work
Use
--
7/ T,
Extg Sq Ft New/Added Sq Ft
!Total Sq Ft
/ pppp
Valuation$ �'�17t7
- —
rl New f` Add Alt er (! Demo
# Stories
77
Check Appropriate Box for Applicant/Notification
(-_! 3. Owner's Name Last (�(�s First
Owner's Address Owner's E-mail Address
City �— Stater Zip Telephone
(- 4. ArchitecfDesigne)s Name LastC� First Lic. No.
- -
ArchitecVDesigne{s Ad_Ass Architect/Designer's E-mail Address
City State r Zip I Telephone—i
F— 5. Engineer's Name Last First L Lic. No.
Engineer's Address Engineer's E-mail Address
City State F Zip Telephone
�—
r 6. Contractor's Name Last First Lic. No.
Contractor's Address Contractor's E-mail Address
City F j //�j - State Zip - �'/ Telephone ��Z -7
OFFICE USE ONLYt �+ty PERMIT NO.
tjlOTYPE OF CONSTRUCTION Y PLAN CHECK NOi
OCCUPANCY -GROUP PLAN CHECK FEE