HomeMy WebLinkAboutF2023-0308 - Permit ApplicationPrint Form
Worksheet for Fire Permit Application U11
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # f_Z_Fire`Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name r I ti� b (D JD y # Units
2. Description Qof Work / _ c,q(' y p xC l,j r
Use �—
Extg Sq Ft 6 I'/ New/Added Sq Ft �— Total Sq Ft �— Valuation $ F1 i QyJ
r New r Add r7 Alter r- Demo # Stories F
pp[ UPI TALC DUx rvr mppncant/Notlncatton
j— 3. Owner's Name Last
First F--
Owner's Address
Owner's E-mail Address
City I
State F_ Zip F_ TelephoneF_
F_ 4. Architect/Designer's Name
Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State �— Zip F_ TelephoneF—
r 5. Engineer's Name Last
First F__ Lic. No.
�—
Engineer's Address
Engineer's E-mail Address
City F—
State �— Zip F_ TelephoneF—
. Contractor's Name Last } IPZi4 A First 5 Al (6�- Lic No. � I L Class C y
Contractor's Address
V Tcdr F1(
Contractor's E-mail Address
City %PC-)u . A p.
State �� Zip TelephoneF
OFFICE USE ONLY
�� C jf Z� PERMIT NO.
TYPE OF CONSTRUCTION
L I PLAN CHECK NO. NC l-' Z `?
�.22�
W] I
OCCUPANCY - GROUP
PLAN CHECK FEE $