HomeMy WebLinkAboutF2022-0077 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
F_ Fire Sprinkler F_ Fire Alarm r— Fire Misc
I
Tenant Name
2. Description of Work
rho' 1I 2 v -j 5-151-gym$
Ur;fi Pr 23 t �,�hsl. vtnt 3 11 y e",IS
Extg Sq Ft F New/Added Sq Ft F-
6( New r- Add r Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Total Sq Ft 3 ��
Floor Suite No
# Units I —
Use
Valuation $ `6SGG
# Stories
Information
r 3. Owner's Name Last
Sq if ycv s P 6e11e10f,7W First �—
Owner's Address
Owner's E-mail Address
City
State F
ZipF— Telephoneg4q-281,Cogy
F_ 4. Architect/Designer's Name
Last
First F— Lic. No. �-
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �-
Zip F- TelephoneF_
F 5. Engineer's Name Last
First F® Lic. No.
Engineer's Address
Engineer's E-mail Address
city
State
Zip F— TelephoneF—
F>�_6. Contractor's Name Last�\��� a First 1 Lic. No. 715S�S Y Class C -
Contractor's Address
Contractor's E-mail Address
zzU-tz b,
CA
lilt.
City Le,
State F4
Zip c126` 1,, Telephone[`6o1-t4_1
OFFICE USE ONLY
�7021-0055
PERMIT NO. F2022 - CC) 77
TYPE OF CONSTRUCTION
PLAN CHECK NO. D 3 $ S'2oZZ
OCCUPANCY - GROUP
PLAN CHECK FEE $