HomeMy WebLinkAboutF2023-0125 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler F1 Fire Alarm ri Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
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Extg Sq Ft F New/Added Sq Ft i Total Sq Ft
New r Add rjC_Alter _I Demo
%_.necn mppropriate aox Tor Applicant(NOtlTication
Floor Suite No
F_ F-1
#Units
Valuation$ , 2J0
# Stories I
i
ri 3.Owner's Name
Last t� jo First--
�.. _ ..�-� ,.ram _ _ --- -- —
Owners Address
( -- ---
Owner's E-mail Address
L , Oce
City -.-_-__ --_- _---.
__. _ ',. State F Zip F— Telephoned --
F_ 4. Architect/Designer's Name Last First F Lic. No.
Architect/Designers Address
Architect/Designees E-mail Address
city
r ---------- -
State — Zip F , Telephone--
F 5. Engineer's Name
Last First
----------— ---- ---- Lic No. F
Engineers Address
Engineer's E-mail Address
City
_ State �— Zip F— Telephone—
r 6. Contractor's Name Last First Lic. No. GC 6
L - M•�% (J4 Class
Contractor's Address
Contractors E-mail Address
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City F
State _ C� Zip U G 2 Telephone J'J7.
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.&24 D6 i
OCCUPANCY - GROUP
PLAN CHECK FEE $