HomeMy WebLinkAboutF2023-0302 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # e --1, [ Fire Sprinkler )(., Fire Alarm ❑ Fire Misc
1. Project Address oot mailing address)
o.
Tenant Name
2. Description of Work
E#g Sq Ft New/Added Sq Ft Total Sq Ft r—�
F- New [ Add r Alter (- Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No�
t � I Y�
# Units
Use W(17i�er- j
Valuation $
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# Stories I_ - W
3. Owner's Name Last T_P_( F C04 � I First-
-- . __ _ .._._ - --
Y
Owner's Address Owner's E-mail Address
City A F0M- state Y6 B Tele hone
( i I Zip � p
r 4. Arch itect/Desig nor's Name Last I First Lic. No.
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Architect/Designees Address Architect/Designer's E-mail Address
City, State Zip
F_ 5. Engineer's Name Last �/ - First Lic No.MIN
- { "�
Engineer's Address Engineers E-mail Address
City �N bl/{�(n State Zip 4 r 7 Telephone
r6. Contractor's Name Last To %t--- / m;7f j rst F—, Lic. No. F Class
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Contractor's Address Contractor's E-mail Address
city.l _ - - - - - _ - - --- State F_ Zip F-7 Telephoner:.
OFFIC€ USE ONLY PERMIT NO. Q'ZO
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $