HomeMy WebLinkAboutF2023-0034 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
Tenant Name 11Y'(�
2. Description of Work
vvorKsheet for Fire Permit Application
City of Newport Beach - Building Division
( f Fire Sprinkler ire Alarm (J` Fire Misc
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Extg Sq Ft j New/Added Sq Ft � Total Sq Ft 4�
--------
❑ New [j Add V'P Alter Demo
Check Appropriate Box for Applicant/Notification
❑ 3.Owner's Name Last
---- ---- i First
Owner's Add
New°oa>
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�Floor
Suite No
# Units
Valuation$ 3� L
# Stories 't
101
ress
Owner's E-mail Address
I
City �— ---- - State Zi
-
�—' p Telephoned---
4. Architect/Designer's Name Last
First �—, Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
--- ------------------
city State
Zip 7 Telephoned---
F 5. Engineer's Name Last First
—..----------- Lic.-No:
Engineer's Address Engineer's E-mail Address
City State �-
---- --- — -- - — Zip Telephone------------
C 6. Contractor's Name Last ' r _
l% t igirFirst Y7 l� Lic. No. ]Z�`1DS Class (,I�
ntractor's Address -- -- --
Contractor's E-mail Address
1� lUY u
city o,
State �- Zip _ �I� ! Telephone����OC�, � ,
----- - ..--`' '
OFFICE USE ONLY PERMITNO. Z fL�
TYPE OF CONSTRUCTION O_�1
OCCUPANCY -GROUP PLAN CHECK NO. 2
PLAN CHECK FEE $ —
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