HomeMy WebLinkAboutF2022-0230 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# i _Z Fire Sprinkler [FireTAlarm El Fire VMisc
1. Project Address (Not mailing ad
&W WtWpaTi Cwllt-r brut.
Tenant Name iivl0.YiOn tYa1
2. Description of Work
"I'Y12 KIOCattOn Uf 2 txl siih C� fiK SpYil1 -leis dvt IM
Extg Sol Ft ! New/Added Scl Ft Total Scl Ft o1c�9t —
New C Add
R,; Alter [—. Demo
—1—m ^.pNr upr racC oux rur AppucanTiNOUTIcation
Floor Suite No
CZ 200
# Units F
e
Valuation $
# Stories
3. Owner's Name Last — —_ First F77:7777 � - k, A
Owner's Address Owner's E-mail Address W
� I
City State —� Zip F Telephone—
_
(74.Architect/Designer'sNanle Last ! First Lic.No.�
Architect/Designer's Address Architect/Designer's E-mail Address
Cih' — _ _ State �— Zip F_TelephoneF-
6. Engineer's Name Last --- First L--.—
Lic. No.
Engineer's Address Engineer's E-mail Address
City �— State Zip—, Telephone
[Z6. Contractor's Name Last First Jpj,r Lic. No. (n2q_ Class C'-I(o
Contractor's Address Contractor's E-mail Address
119 mar Voacl. Sv+it ii - _Jdnn@ W ro f irc inc• corn
city Loctonsiclit State La,---- Zip g2o5B Telephone q5I, 2 11"
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
V
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $ —