HomeMy WebLinkAboutF2023-0235 - Permit Application (2)Print Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not
Tenant Name
Worksheet for Fire Permit Application r- ~r
City of Newport Beach - Building Division
�eF
Fire Sprinkler F_ Fire Alarm r Fire Misc
address) Floor Suite No
cl
2. Description of Work
yet rd MM 4 0 Ste► in -e,�yj
`rnpu
Extg Sq Ft �'V— New/Added Sq Ft �— Total Sq Ft
F_ New F_ Add Alter j_ Demo
Check Appropriate Box for Applicant/Notification
# Units F
Use U a
Valuation $�
# Stories F
j` 3. Owner's Name Last C��Lu,� First t�J
Owner's Address
Owner's E-mail Address
City
State �— Zip �— Telephone G�(�rr—z
Architect/Designer's Name Last
rn� ' First lI Vr t l/G�— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
/]Its �j
State l I /l l— 1/J Zip r Telephone 5 ✓ !! 7 l �(
�� J
5. Engineer's Name Last—'
Firs��tUUF— Lic. No. �—
Engineer's Address Wy `(/�y
V Engineer's E-mail Address
City �
State �— Zip �— TelephoneF—
I— 6. Contractor's Name Last
First 7— Lic No. J�L� Class L
p p�—
Contractor's Address P,(t Ul
/ ( S�// ✓ ,Contractor's E-mail Address
F)TI dT&
City I
Stater Zip Telephone
OFFICE USE ONLY
PERMIT NO. 50
TYPE OF CONSTRUCTION
'•
mg 811
PLAN CHECK NO. OM 7q
OCCUPANCY - GROUP
PLAN CHECK FEE $