HomeMy WebLinkAboutF2022-0558 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # xapa- I qz# F; Fire Sprinkler ire Alarm
rl Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name t✓ # Units PK
2. Description of Work
Use
yk jA1G�V4ln �'= Ct�l��1�� `� StY�x/ jtraS
Exlg Sq Ft F�'.. New/Added Sq Ft �, Total Sq Ft \mil t-F�� -'.
Valuation$ ��I
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F New I—•... Add Alter F_ Demo
# Stories F-i,
Check Appropriate Box for Applicant/Notification
(-, 3. Owner's Name
Last i CW First
Owner's Address
Owner's E-mail Address
City
State Zip Telephoned---
F_ 4. Architect/Designer's Name Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip F Telephoner
5. Engineer's Name
Last First Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State F— Zip �— Telephoner .
(- 6. Contractor's Name
Last ; ( �` EY First I Lic No. h2qc Class C/O
Contractors Address
Contractor's E-mail Address
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city �ok—
State r Zip _- ��,4U Telephone ����.
OFFICE USE ONLY
e?(,24 0 PERMIT NO. F20-u, ouss
TYPE OF CONSTRUCTION
2s $ PLAN CHECK NO. 26ZO22' 2-113
OCCUPANCY - GROUP
2( PLAN CHECK FEE $
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