HomeMy WebLinkAboutF2023-0122 - Permit ApplicationWorksheet for Fire Permit Application oan
City of Newport Beach - Building Division o
Please print 3 copies Gaon
Associated Building Permit# _� Fire Sprinkler F-;Fire Alarm Fire Misc aj n
1. Project Address (Not mailing address) Floor Suite No
Tenant Name -C-14-,(f.se_�eS)r,+v-v+�C —� #Units F
2. Description of Work
6 c I�.Sn Y� �� Sy STIUiv.
Extg Sq Ft New/Added Sq Ft � Total Sq Ft �—I
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F-1 New F_ Add Alter F7 Demo
Valuation $
#Stories F 7,
III 3 i
� 11m;K m.ppropnate aox for AppiicanUNotiticatlon
3. Owner's Name Last I
i First
Owner's Address Owner's E-mail Address -
I
City StatezipZip �— Telephoned
4. Architect/Designer's Name Last First � Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City Tel
State 177 Zi p F— p F
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[i 5. Engineer's Name Last p� First
All�G Lic. No.
Engineer's Address Engineer's E-mail Address
City _O��r State Zips p Telephone
C 6. Contractor's Name Last First Lic No. � %� ;5 Class
Contractor's Address Contractor's E-mail Address
F-- _5 1 Gt r=r t �tC. n� Pc4� c.��_
City - ,rJ State I Zip _ C �G� _ Telephone. . �I5,�,b
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OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.G
OCCUPANCY - GROUP PLAN CHECK FEE $