HomeMy WebLinkAboutF2023-0013 - Permit ApplicationWorksheet for Fire Permit Application(r,5,
City of Newport Beach -Building Division Please print 3 copies
Associated Building Permit # (—•- Fire Sprinkler F—, Fire Alarm �; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name # Units �-
2. Description of Work /
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Extg Sq FtF��n///'��// // l\f' Total Sq Ft New/Added Sq Ft Valuation
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# Stories F
_ New � Add r' Alter f-`.. Demo
check Appropriate Box for Applicant/Notification
(- 3. Owner's Name Last First
Owners Address
Owner's E-mail Address
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State IT
Zip �� Telephoned---
f— 4. Architect/Designer's Name Last
First F Lic. No. F—
Architect/Designers Address
Architect/Designer's E-mail Address
City
State —
--
Zip Telephone
i— 5. Engineer's Name Last
First — Lic F-- No. I
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Engineer's Address
Engineer's E-mail Address
City - _
State �—
Zip F Telephoned
6. Contractors Name Last
First Lic. No. F— Class—
Contractor's Address
Contractors E-mail Address
City QS -
State YL
zip DO5 Telephone
OFFICE USE ONLY
PERMIT NO.yi!"p0�j
r—
TYPE OF CONSTRUCTION
PLAN CHECK NO. T-WI-5-
OCCUPANCY - GROUP
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PLAN CHECK FEE $
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