HomeMy WebLinkAboutF2023-0066 - Permit ApplicationX 2022 2 6 C1 Worksheet for Fire Permit Application
City of Newport Beach - Building Division i
Please print 3 copies o%VV 6/'
Associated Building Permit # F Fire Sprinkler Fire Alarm F7 Fire Misco
1. Project Address (Not mailing address) Floor Suite No
Tenant Name # Units F
2 Description of
I/Work
!es _(. I _, \/,I/yl ? .1 S Use �`v �c-�-
V Valuation $
Extg Sol Ft New/Added Sq Ft Total Sq Ft
'-$Oew F_Add r— Alter j—, Demo It Stories
Check Appropriate Box for Applicant/Notification
f— 3.Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State �— Zip F— Telephoner
4. Architect/Designer's Name
Last First Lic. No. �—
Architect/Designees Address
Architect/Designers E-mail Address
City
State �— Zip F — Telephone!
F_ 5. Engineer's Name Last
First I
Engineer's Address
I
Engineer's E-mail Address
i
City ` Ste Zip �— Telephone J�'J 60
+6. Contractor's Name Last
C First Lic No Class
Contractors Address
City , (6 co/c, / 4 c„ �
Contr ctors E-mail Address
State I 6V— Zip �2 j l— Telephon
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. PGL^— 0 27
OCCUPANCY - GROUP
y�7 Fes/ I _ PLAN CHECK FEE $
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