HomeMy WebLinkAboutF2024-0006 - Permit ApplicationWorksheet for Fire Permit Application o�EW "rA
Print Form z�
City of Newport Beach -Building Division
Please print 3 copies
Associated Building Permit #
0 Fire Sprinkler (— Fire Alarm Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
3(P I s 61/1 r vl ew
lam, I )twpoi L- beach) f',
--- �----
Tenant Name U' IUJ
W p niq
(`r] n of p
J lLt.� 1. Ci
# Units F
2. Description Work
/oof.{n
Use-------
Extg Sq Ft
�—,
New/Added Sq Ft Total Sq Ft M1) MU
Valuation $ Rptwo .
New I— Add r..
1
Alter r' Demo
#Stories
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last ��`- Vim �� First iVgl t ll,�
Owner's Address
Owner's E-mail Address
City I Maw RL Y State FM_
Zip [8i Telephone U1'1- 2-96-1"ijo
i— 4. Arch ltect/Designer's Name Last
First F` Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F_ State F_
Zip [_ Telephonel��
r 5. Engineer's Name Last I
First Lic. No.
Engineer's Address
Engineers E-mail Address
City � State F_
I
Zip I — Telephone)—_
j� 6. Contractor's Name Last First �/) )/y� Q S — Lic No. 1vgjot q Class C U
Contractor's Address
Contracr's E-mailE Address
M- w jebd lci
11�mrM dimco-o e. om
City MOOi State Imo—
Zip (Y�- TelephoneFNq�jU-l�}
OFFICE USE ONLY
PERMITNO. ib
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $