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HomeMy WebLinkAboutF2021-0289 - Permit ApplicationWorksheet for Fire Permit Application (FQ%,Print Form City of Newport Beach - Building Division Please print 3 copies Associated Building Permit Z ( Fire Sprinkler FSCEireAlarm F- Fire Misc 1. Project Address (Not mailing address) Z60t WeiIcI Vr?P < A3DD Tenant Name 416e5 f 2. Description of Work l/ T Extg Sq Ft �— New/Added Sq Ft F— Total Sq Ft YQ p v F- New ;< Add F- Alter F_ Demo Check Appropriate Box for Applicant/Notification Floor Suite No # Units F Use �VValuation $ �j�dp 2 # Storie �j -U -SP�Z F- 3.Owner's Name Last ?4/-cY Owner's Address Owner's E-mail Address City PCT QC9�� State (•aq. ,� Zip g Telephoned r- 4. Architect]Designer's Name Last First �— Lic. No. F Arch itect/Designer's Address Architect/Designer's E-mail Address City State F_ Zip F Telephoned F_ 5. Engineer's Name Last First F_ Lic. No. Engineer's Address _ Engineer's E-mail Address City � State F_ Zip Telephoner— F_ 6. Contractor's Name Last ` u� 1•�,..t First ✓�S�N Lic No. 70,�'IC1a5s Contractor's Address Contractor's E-mail Address City �)"/�/Ih.,Q State `/} Zip %2&f Telephone ys) 293-345- OFFICE USE ONLY PERMIT NO. l' ZO -( — D J6 TYPE OF CONSTRUCTION PLAN CHECK NO. \56S OCCUPANCY -GROUP PLAN CHECK FEE $ o31 -2joC