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HomeMy WebLinkAboutF2022-0421 - Permit ApplicationWorksheet for Fire Permit Application oPoiv Print Form \ City of Newport Beach - Building Division M : please print 3 copies tf L u �7, Q Z f <iFOwN Associated Building Permit # X'20,2,7 - 0Gj/� P Fire Sprinkler rI Fire Alarm r Fire Misc 1. Project Addre%s�sf(Not mailing address)/ Floor Suite No �000 C-" 12�p oa Tenant Name # Units 2. Description of Work _N V14 0 ka.l I r e;-U% Re- a S _,7, rev' JA)" 6&;1,'uD Extg Sq Ft New/Added Sq Ft �� Total Sq Ft �— F_ New (— Add Alter r- Demo Check Appropriate Box for Applicant/Notification Use Valuation $ # Stories F 3. Owner's Name Last First F Owner's Address Owner's E-mail Address i City State �— Zip �— Telephoned_ r 4. Architect/Designer's Name Last �J First F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City �— State F Zip �� Telephone�� F_ 5. Engineer's Name Last First F Lic. No. �— Engineer's Address Engineer's E-mail Address City State F— Zip F Telephone �6. Contractor's Name Last I APeA r ,��5 First Lic. No. 7323 !�o' Class —' Contractor's Address Contractor's E-mail Address Z16 %<>. M rAve- P-,r- .God City 14 Ka State G1A Zip q-Z7©!.f Telephone qf? g 7 ZC�vrG� OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY - GROUP PLAN CHECK FEE $