HomeMy WebLinkAboutF2023-0306 - Permit ApplicationWorksheet for Fire Permit Application o4�E"°°�m
City of Newport Beach - Building Division
Please print 3 copies c��'o,,,.�
Associated Building Permit # j Fire Sprinkler F' Fire Alarm F—i Fire Misc
1. Project Address (Not mailing address) Floor Suite No
_9400 Mac'RrtYtur 13ovle> va�d _._
Tenant Name fjdaG NaN0nQ1 V #Units
2. Description of Work
The rttoatiion of C211 evistirrcJ fire. 6ptinyitir hcads d1A W) her,i._L%Jap.,--.-.--.. =Use _mod RCc
and tight locations.
Valuation $ 2,3oo_ool
EMg Sq Ft New/Added Sq Ft , Total Sq Ft �,gt9(o _! �—
# 1 9
[I New [Add rj Alter F Demo Stories
I '
Check Appropriate Box for Applicant/Notification
[3.Owner's Name Last pet Cacmen Vi11o1uz First Jarlhept
Owner's Address
_._
Owner's E-mail Address
7.010 Mdtn Street, sui}c 5�0
city
State G�j_ Zip gZ(cl4 Telephone (ggq�331 13oO
4. Architect/Designer's Name Last
— _ J First— Lic. No.�-.
Architect/Designer's Address
ArchitecVDesigner's E-mail Address
City
State I Zip [7777 Telephone-
5. Engineer's Name Last
First— Lic. No.I
Engineer's Address
Engineer's E-mail Address
City _ _ _
State F—' Zip F—� TelephoneF—
['6. Contractor's Name Last First John Lic. No. (v29993 Class
Contractor's Address
Contractor's E-mail Address
1 Iq 9_%1Ylar ?ROcu Sulc }1
John@aqrofirtihC-corn
City occansidt.
- -
State CFt Zip C(X� Telephone (9602G f-!AIZ
OFFICE USE ONLY
�G/iCJ%3 — O 6 Z S PERMIT NO. EZ--AfU — C)3 C7
TYPE OF CONSTRUCTION
JCG ZtRZ 3 L)DO 3 PLAN CHECK NO. PG4C('3 ' 1
OCCUPANCY - GROUP
2'WZ-3 — U 73 Z PLAN CHECK FEE $