HomeMy WebLinkAboutF2021-0577 - Permit ApplicationWorksheet for Fire Permit Application Please print 3 copies �dFOP„ o��Re
City of Newport Beach - Building Division g '
u
Associated Building Permit # j Fire Sprinkler r Fire Alarm ri Fire Misc
1. Project Address (Not mailing address) Floor Suite No
J—O$,2)q FJea
- -- ,fit F- j��-
Tenant Name ►•�AI(�5 j #Units I
2. Description of Work 1
fiw�.kSw p�ov�.le AdOlOf-
'4leas rG 21 hF}ols- ko -flja / wsil -Use
Ext S Ft I Valuation $ l y�6
9 Q �— New/Added Sq Ft � Total Sq Ft—� +
New [ Add [ Alter [ Demo # Stories
First
1- 3.Owner's Name Last l� y(v,L (� --
Owner's Address
--I
Owner's E-mail Address
City IfVW��
--------- ---
State Zip F Telephone I
[' 4. Architect/Designer's Name Last
FirstFIC-MLic. No.
Architect/Designers Address
Architect/Designees E-mail Address
N17Loft�F:r4-fr*t%,(k:a,OR
nw\
City+d"'- (', t' - -- —
—
State Zip �1 TelephantSy—
F. 5. Engineer's Name Last _
First 177777Lic. No.
Engineers Address
Engineers E-mail Address
City
i
State—ZiPF—! Telephoner
6. Contractor's Name Last (p U� First \ �` Lic. No. ��--LBS Class
Contractor's Address
Contractor's E-mail Address
1.
City uliitw _`
lac __.---- --
State �— Zi �� SC� P
p Tele hone 1 nao G
/
_._ ,
OFFICE USE ONLY
Imo{ )S,° � PERMIT NO. ?.og:4 . pS
TYPE OF CONSTRUCTION
(��/0,U IL 9 PLAN CHECK NO. Z��� •2 �
OCCUPANCY - GROUP
Z,6r PLAN CHECK FEE$
.� ► ►► ► r/►
�70Ll --0c.o o I