HomeMy WebLinkAboutF2023-0200 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing adc
160 sgtwlew Circle -
Tenant Name I Spec Pik. 4h(30
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
IX Fire Sprinkler F_ Fire Alarm (- Fire Misc
Floor Suite No
4i; 4�400
# Units F
.,.� .,wY, ur wuxn il)uIvLKJ .the rLloalnon aria Qoajmro of $ }iTe SpYihkl2r Use I pj-OF'ticR.
cads- due 6
h hew.- wall aria _liyh}_Ia�oukS.
Extg Sq Ft F— New/Added Sq Ft F— Total Sq Ft 1, qValuation $ 2(o4. 000.0a-
r New r Add Alter r- Demo # Stories
a.. nGun r+Nl.rropnale Cox Tor Appiicant/NOtiticatiorl
r 3. Owner's Name Last
C-dwatc\S
_
First Jear,nic
Owner's Address
Owner's E-mail Address
100'aat iew CIrcIQ, &;jiC230
City [ Wewport iB2GG1'1
State
[ C�
Zip c(2(oOCo Telephone—
r 4. Architect/Designer's Name
Last
First F— Lic. No.7
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
F—
Zip [_ Telephone—
r 5. Engineer's Name Last
_....
First—Lic. No. F_
Engineers Address
Engineer's E-mail Address
City
State
F—
Zip F— TelephoneF_
P< 6. Contractor's Name Last 30i1nS}Gn
First jphn Lic. No. (02acl93 Class Flu
Contractor's Address
Contractor's E-mail Address
vict I?oywckf 1Road, soi1C it
jphn@allprofiYf inc Com
City ORZOL d,
State
�—
Zip FC120515 Telephone (CISI) Z(c4. 3g12
OFFICE USE ONLY
Z�2 �ZLZ7 PERMIT NO.
TYPE OF CONSTRUCTION
ZZ3 PLAN CHECK NO. Pr✓ZtnJ� -IOdi�
OCCUPANCY - GROUP
q
t
`b PLAN CHECK FEE $