HomeMy WebLinkAboutF2022-0342 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building, Division '' S
Please print 3 copies F
1 V
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Associated Building Permit # J Fire Sprinkler ❑ Fire Alarm F—, Fire Misc
1. Project Address (Not mailing address)
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Tenant Name U 0\ GVA �r2 j\C%-e
2. Descripi
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of Work
Extg Sq Ft -,`_) �_ New/Added Sq Ft Total Sq Ft <
77 New 7 A� dd F- Alter n Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
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# Units L
Use I _�\�
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Valuation $ �.
#Stories
3. Owner's Name Last vC- �� Firs _ _ V j_o J
Owner's Address Owner's E-mail Address IV
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City State `�I Zip tp 2 Telephone L j Z�J ci
4. Architect/Designer's Name Last �) j First V Lic. No. S S2 z
Architect/Designer's Address ��� ` L�l � Y`e,�,( a I UG' Arohi ect/Designer's E-mail Address
City State Zip Telephone
5. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
I`! 6. Contractor's Name Last` First �Cj�-�� Lic. No. Class
Contractor's Address Contractor's E-mail Address
P-y 30 `C(AM
City Ac� ���C� ( t — State Zip r Telephone
OFFICE USE ONLY PERMIT NO. d--<>
TYPE OF CONSTRUCTION PLAN CHECK NO. ` ^ �z
OCCUPANCY - GROUP G , o16 PLAN CHECK FEE $