HomeMy WebLinkAboutF2024-0060 - Permit ApplicationWorksheet for Fire Permit Application u
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit #
(_ Fire Sprinkler F_ Fire Alarm I— Fire Misc
1. Project Address Not mailing address) Floor Suite No
F-14-43 Firow f4warell F11 F_ f
Tenant Name # Units F
2. Description of Work
L LL�
/hs*// n� h4pilew StWe��% w/ � ;�!
Use
Extg Sq Ft �— New/Added Sq Ft �— Total Sq Ft �
Valuation $ W/ooD
(— New r Add (— Alter (— Demo
# Stories
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last
First r2
Owner's Address
Owner's E-mail Address
City State
Zip [_ TelephoneF_
r 4. Architect/Designer's Name Last
First
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State
F—
Zip [— Telephonel—
f— 5. Engineer's Name Last
First F
Lic. No. FJ
Engineer's Address
Engineer's E-mail Address
City f State
F—
Zip �— Telephoned
i— 6. Contractor's Name Last s1firarlb No.
F715$69 Class FC--kip
Contractor's Address
Contractor's E-mail Address
22*12 Css"6v&-
City State
F—
Zip �— Telephoned
OFFICE USE ONLY
PERMIT NO.
V;Mq� O 960
TYPE OF CONSTRUCTION
PLAN CHECK NO.
PL202 —02Z L
OCCUPANCY - GROUP
PLAN CHECK FEE $