HomeMy WebLinkAboutF2024-0242 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler r Fire Alarm i— Fire Misc
1. Project Address (Not mailing address)
Tenant Name _ . � P& I-(
2. Description of Work
Extg Sq Ft �— New/Added Sq Ft - Total Sq Ft
I— New I— Add IX Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use
Valuation $ )� I G
# Stories
r 3. Owner's Name Last
First F_
Owner's Address
Owner's E-mail Address
City -
State F_ Zip
F_ Telephoned
F 4. Architect/Designer's Name
Last FirstF Lic. No.
F
Architect/Designer's Address
Architect/Designer's E-mail Address
City I—
State F— Zip
F— Telephone
(- 5. Engineer's Name Last
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State I— Zip
I Telephoned
f(6. Contractor's Name Last {�( Oc it ICE o
��++
, l��I'I, i Lic No. Z� N I� Class C I �;
FirstFT
Contractor's Address
Contralctor's E-mail Address
`_7j')1Y1 ✓, C
city V � �L� j
State rcA Zip
(ij l �'(y' � Telephone ] ( Ln
OFFICE USE ONLY
PERMIT NO. 7..
TYPE OF CONSTRUCTION
PLAN CHECK NO.
Q
OCCUPANCY - GROUP
PLAN CHECK FEE $