HomeMy WebLinkAboutF2021-0011 - Permit Application (3)Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Pi .ase r 'nt 3 copies
Associated Building Permit #
1. Project Address (Not mailino address)
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Tenant Name _ �.�1/l. UM Sft`Q*1
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P Fire Sprinkler [i Fire Alarm n Fire Misc
Floor Suite No
# Units r
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2. Description of Work
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NCQ_ Ins-�A. _ inn 3m h
EMg Sq Ft �- New/Added Sq Ft cRb Total Sq Ft F
r New j— Add r Alter F— Demo
Check Appropriate Box for Applicant/Notification
Use
J�aotion $ J� rJv u
7
Stories F
[, 3. Owner's Name Last First : l iU RA
Owner's Address Owner's E-mail Address
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r, � � State r/� �� r' ^.
City lvp_PDpi - I 5 Zip Telephone JiW Q'Jb'tB`t'ot
4. Arch itectlDesigner's Name Last First Lic. No.
111 _
Architect/Designer's Address Architect/Designers E-mail Address _ _
City State Zip
5. Engineer's Name Last �oi�rrl0�V1(S4 First CAYIs Lic. No. F
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Engineer's Address Engineers r�E-mail Address 77
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City m State Zip -" lll� Telephone I
76.Contractor'sName Last �1�\�, U,� �pp ���1/IAA FirstF noVn�ee p( Lic. No. 'i
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Contractor's Address Contractor's E-mail Address
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CRY �. - .. .. State Zip ( gD Telephone.,' iq 6�Dr
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION _ PLAN CHECK NO. 0'02"aQij
OCCUPANCY - GROUP PLAN CHECK FEE $