HomeMy WebLinkAboutF2023-0203 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
I. Project Address (Not
Tenant Name
2. Description of Work
add
Worksheet for Fire Permit Application
City of Newport Beach - Building Division i
I (-; Fire Sprinkler )i6j Fire Alarm [-1FireMisc
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bXV, 663,
Extg Sq Ft �- ,I New/Added Sq Ft �11Total Sq Ft FI
F j New F. Add r; Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
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F
#Units
Use
Valuation $
F33�_
# Stories
3. Owner's Name Last � t . I First —
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Owner's Address -
2_0`� rr Owners E-mail Address
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City ® �j i State j Zip •-t Y�i -® Telephone
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C 4. Arch itect/Designer's Name Last
Architect/Designees Address
First F
Architect/Designer's E-mail Address
Lic. No.l
city -_ - _. - _ -- - - - - - -_ - State Zip Telephone�__-____
F' S. Engineer's Name Last I ' F _I First j �'
_'.__ Lic. No.
Engineer's Address
Engineers E-mail Address
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city D ,
�( bl/iYn State F Zip l P 7 Telephone)
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1_.!ti. contractor's Name Lastl(
Lic. No, Class
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Contractor's Address
Contractors E-mail Address
state
- - - 1—� Zip F__---, Telephone—_-.__.-_..
OFFICE USE ONLY
TYPE OF CONSTRUCTION _
OCCUPANCY - GROUP
PERMIT NO.�'�
PLAN CHECK NO.
PLAN CHECK FEE $ ---___