HomeMy WebLinkAboutF2022-0480 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # (- Fire Sprinkler Fire Alarm n Fire Misc
1. Project Address (Not mailing address)
Tenant Name .. __!j-_ 44P-i�
2. Description of Work
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EMg Sq Ft F—] New/Added Sq Ft � � Total Sq Ft
New j-; Add [— Alter j^, Demo
Check Appropriate Box for ApplicantlNotification
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Floo Suite No�
# Units
Use
Valuation $
# Stories F7
3. Owner's Name Last TR i P C04MY First
Owner's Address Owner's E-mail Address
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Ci G/ 1 State 1 zipY(� 0 Telephone
-- ---- - - --
F_ 4. Arch itect/Designer's Name Last First �^
Lic. No. �—
Architect/Designers Address Architect/Designer's E-mail Address
City State �— Zip Telephones-
6. Engineer's Name Last First I l ' " <
Lic No. 1
Engineer's Address Engineers E-mail Address
City / G' (>I/ State Fc Zip � (� Telephone � UR ^ _;.,q ��OJ "f -- — —
r 6. Contractor's Name Last f O dl'= 'b R rst�—j Lic. No. F
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Classr
Contractor's Address Contractors E-mail Address
City, - State Zip F Telephonel'
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OFFICE USE ONLY PERMIT NO.
fPPz2-- 9+00
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $