HomeMy WebLinkAboutF2023-0053 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division z
Please print 3 copies
Associated Building Permit # F F. Fire Sprinkler n' Fire Alarm ri Fire Misc
1. Project Address Not mailing address) Floor Suite No
Tenant Name 1 - iYjz ...(SK r<�S jA G1Aflr,,< # Units
2. Description of Work
Use
EMg Sq Ft �—,, New/Added Sq Ft � � Total Sq Ft �
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Valuation $ �1_ —:-
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r New ( Add r Alter r Demo
# Stories�/�,—
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Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last I First —
Owner's Address Owner's E-mail Address
City IT � % State 4 Zip �%�� d Telephone—
r 4. Architectt/Desiigner's Name Last I First Lic. No.
I—
Architect/Designer's Address Architect/Designer's E-mail Address
City State- Zip Telephone—v--
r 5. Engineer's Name Last X`jt First [ [ Lic No.
- -- - ----- `- -
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Engineer's Address Engineers E-mail Address
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City 4W wlp A, State L C Zip 1 [ 7 Telephone
F !6. Contractor's Name Last T f_36t—_ 'DR*M� rstU.N.. Class
Contractors Address Contractors E-mail Address
City,-- - -. - - -_--_ State �-- Zip—;, TelePhone'_
OFFICE USE ONLY PERMIT NO. r w vez� — (XJ S3
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $
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