HomeMy WebLinkAboutF2023-0169 - Permit ApplicationPrint Form Worksheet for Fire Permit Application�E/�j^,�R
Please print 3 copies
City of Newport Beach - Building Division
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Associated Building Permit # )(C- ft23 r Fire Sprinkler ire Alarm Kl / ��-� � r fire Misc
1. Project Address (Not mailing address)
Floor Suite No
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Tenant Name L �/l
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2. Description of Work
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Extg Sq Ft F— New/Added Sq Ft �— Total Sq Ft 7:L ,7 t`
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F- New F- Add VAlter F- Demo
Check Appropriate Box for Applicant/Notification
F 3.Owner'sName Last IYv`�AC
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Owner's Address
Owner's E-mail Address
Use I FAA
Valuation $
#Stories F
City I State I— Zip I -Telephone
F- 4. Architect/Designer's Name Last First [�
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I State I— Zip I— Telephone—
r 5. Engineer's Name Last First F�
Lic. No. F —
Engineer's Address Engineer's E-mail Address
City I State I— Zip [— Telephone�—
tp. Contractor's Name LastR'(/It\ IA� First /�'� j�
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Contractor's Address Contractor's E-mail Address t
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OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
6( LAN CHECK NO./
.0DbbPLAN CHECK FEE $
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