HomeMy WebLinkAboutF2023-0474 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r- Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2F_ F—
Tenant Name -Odd
I �� #Units F-
2. Descriotion of Work
Nbd s�) 1G\kf, SsfiQ ,2j� Y ��1 S Use I
Valuation $ �pn/
Extg Sq Ft F_ New/Added Sq Ft F Total Sq Ft
(- New F_ Add r Alter r Demo # Stories
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First
Owner's Address
Owner's E'-mail Address
211) 1
g m vJ (th R Q, DL dh 00 - QM
City I State �-� Zip
� TelephoneF_
F_ 4. Architect/Designer's Name Last
First 7— Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State �- Zip
r— Telephoner
r 5. Engineer's Name Last l.011 j-�D fo o\ f-First P r� OV\ Lic No.
Engineer's Address
Engineers E-mail Address
City State ri Zip
F_ Telephone—
r6.Contractor'sName Last CjA 1j-�Or 0'6t N�
First�hl�O(.jc.No. j `VjBjClass �' -F
Contractor's Address
Contractor's E-mail Address
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alyV\i0c) 41x l/ 000c,
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City C a � C � � State Zip
�'Ztp1?71- Telephone 01 t t1 1) 2-l l .- I 4�
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OFFICE USE ONLY TC20�,, . 04l
PERMITNO. )�
TYPE OF CONSTRUCTION �� ��` PLAN CHECK NO. 2-" '?�' `- 11
OCCUPANCY - GROUP
PLAN CHECK FEE $
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