HomeMy WebLinkAboutF2024-0025 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # 7\ Fire Sprinkler r Fire Alarm (— Fire Misc
1. Project Address (Not mailing address)
5-0 q 3� �L s 4,
Tenant Name l I VVICnq&
2. Description of Work
41 1, Ic let- 3 z°u1 3
Extg Sq Ft `jl_ 5i ji New/Added Sq Ft F Total Sq Ft
New F— Add Alter F_ Demo
Floor Suite No
# Units F—
Use
Valuation $ FOo
# Stories
Check Appropriate Box for Applicant/Notification A
F" 3. Owner's Name Last CG_ I���
First fi /'G tic
Owner's Address
Owners E-mail Address
City � G State F I,
ZiP I Telephone a, 3. ^ V —�Wq
F- 4. Architect/Designer's Name Last I lC44M pn/y
First CND1t7 Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
SSr r/ Q V G u .(Gt (ti In
City ✓
1 4,( State FK
Zip C:)%I 6 Telephone qf,(q'
F— 5. Engineer's Name Last
First I Lic. No.
Engineer's Address
Engineer's E-mail Address
City State F—
Zip F_ TelephoneF—
F- 6. Contractor's Name Last I C, I First �� Lic No. lo3 n7 class G 16
Contractor's Address
S
Contractor's E-mail Address
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U, MrA�-+l Hz-Z JQ 091 4 0N4V I Zo�7
City I M( 0 Plop I c State or—
Zip �I � G Telephone u & - �5s %
OFFICE USE ONLY
PERMITNO. 2o2q- oozy
TYPE OF CONSTRUCTION —
PLAN CHECK NO. 4— 046
OCCUPANCY - GROUP
PLAN CHECK FEE $