HomeMy WebLinkAboutF2021-0613 - Permit ApplicationL_v Worksheet for Fire Permit Applica ^n _
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- City of Newport Beach - Building Division )�1
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Associated Building Permit # per f/ /) _ �/r y [ ire Sprinkler [ Fire Alarm C Fire M3 _
1. Project Address (Not mailing address) S�uIt�ee N
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F7
Tenant Name - t(,Aj C1, M M.e_�_ - _— #Units
Tenant
2. Description of Work
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-Use.
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Extg Sq Ft New/Added Sq Ft Total Sq Ft � �Too
Valuation $ .
Architect/Designer's E-mail Address
New [ Add [ Alter [ Demo
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-A-SF�
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last 0 First
Owner's Address
Owner's E-mail Address
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City
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❑ 4. Architect/Designer's Name Last �— — I First L Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City.
State F_, Zip Telephone-
[ 5. Engineer's Name
Last 4w. pt ✓I Cyt Lic. No.---------------
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Engineer's Address
Engineer's E-mail Address
City _
_ State —' Zip L Telephone n5717i3. T6t� -3 6
[6. Contractor's Name Last A I1 -� V(J First Lic. No. ���JClass I
Contractor's Address
Contractor's E-mailAddress
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City L
State Zip elephone
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OFFICE USE ONLY
PERMIT NO. - 1
TYPE OF CONSTRUCTION
PLAN CHECK NO ' (J l /�-
OCCUPANCY - GROUP
�� / i [ PLAN CHECK FEE $