HomeMy WebLinkAboutF2022-0340 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies U
Associated Building Permit # Fire Sprinkler (v Fire Alarm [Fire Misc
1. Project Address (Not mailing address)
_W L°tr}-- C.�(r��E�t�___l•��._..1vF'��C�i�-__�(��i�li___-_�._�___ _-
Tenant Name j UN�/ - _-_ J _ �� ��1� •_- -- Cq.C--�l-- -
2. Description of Work
Extg Sq Ft7777 New/Added Sq Ft
Total Sq Ft`
rj New [-, Add [ Alter F. Demo
Check Appropriate Box for Applicant/Notification
information
�'; 3.Owner's Name Last First
h. L_/V _n�_— rt _ .... - - - --- ----
Owner's E-mail Address
Floor Suite Nk
# Units
e Pit' i
Valuation $ i r;, Coe)
i
# Stories Fj
Owner's Address --
^ Zip rJ Telephone �Yif -�'
State t p '( r%, fv �. .. q p r
city l r�-- -
First Lic, No
4. Architect/Designer's Name Last -- -- - - - --
Architect/Designer's Address Architect/Designer's E-mail Address
State Zip !NTelephone
city - -- -
----
•
Last First Lic. No.
5. Engineer's Name _ 4 - - -
Engineer's Address
Engineer's E-mailFAddress
-- - -
State Zip Telephone
City - -
First Lic. No. _�;�� Class
X6. Contractor's Name Last _COr ny�
Contractor's Address Y Contractor's E-mail Address
I
State— Zips Telephone j - i Ul ,5lt�
city
PERMIT NO.
OFFICE USE ONLY N ;) r� ,.�v1 �/�
�1 tJi,J U n PLAN CHECK NO.
TYPE OF CONSTRUCTIO I/
OCCUPANC-40
Y - GROUP �b �O O q IPLAN CHECK FEE $
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