HomeMy WebLinkAboutF2022-0604 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3copies
1 //" C94Po0.XP
Associated Building Permit # j ('Fire Sprinkler r; Fire Alarm F_l Fire Misc
1. Project
Tenant Name
2. Description of Work
mailing address)
Extg Sq Ft New/Added Sq FtTotalTotal Sq Ft
F—; New rl Add r Alter F_ Demo
Floor Suite No
1� 2irj I
-77
#Units F
Valuation $ —
JI
# Stories
VP 91W1VWL111�QL1VJJ
3.Owner's Name Last F_ First
Owner's Address Owner's E-mail Address
i
i
City
State Zip Telephone
4. Architect/Designer's Name Last77777777 First F— Lic. No F_,
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip [77777 Telephone __ —
F 5. Engineer's Name Last First
Lic. No,
Engineer's Address Engineer's E-mail Address
City State �— Zip �— Telephoned
F 6. Contractor's Name Last �� ,� p7r First Class7_IZ
Contractor's Address { Contractor's E-mail Address
City -----.._ 1�` ) �_.- State I —/ ` Zip--_/%sQ _ Telephone[EOFFICEUSE ONLYPERMIT NO, �� ZZs Q0F CONSTRUCTION PLAN CHECK NO. VC2 Z'Zg7lANCY - GROUP
PLAN CHECK FEE $