HomeMy WebLinkAboutF2023-0099 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# -.... -... -_.-I F Fire Sprinkler ?PireAlarm Fire Misc
(Fe
952py')
1. Project Address (Not mailing address) Floor Suite No
CIF
Tenant Name-11U1,1VU„�S �`' ��;ryv j #Units
JJ
2. Description of Work
_ use
Gldd0� V?- Y /Si 1a� �r3 tib S
Extg Sq Ft r New/Added Sq Ft I�---� Total S Ft
I q i3i$OD
Valuation $
F New F—, Add Alter r Demo
# Stories
Check Appropriate Box for Applicant/Notification
F; 3. Owner's Name
Last First �—
Owner's Address
Owner's E-mail Address
--
City I
State �— Zip F— Telephoner
4. Arch itectfDesigner's
Name Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
city r
State r-- Zip Telephone
F_ 6. Engineer's Name
Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State r-- Zip F_ Telephoner--
r 6. Contractor's Name
Last First F— Lic. No. r-- Class r--I
Contractor's Address
Contractor's E-mail Address
City
- State F— Zip r-- Telephoner----',
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO. ZC�2
OCCUPANCY - GROUP
PLAN CHECK FEE $