HomeMy WebLinkAboutF2022-0023 - Permit ApplicationWorksheet for Fire Permit Application OWN -
City of Newport Beach - Building Division
Please print 3 copies
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Associated Building Permit # F_j Fire Sprinkler Fire Alarm El Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Owners E-mail Address
Tenant Namel Wvjllvb� Se&61 Giolf Cdv2r2 # Units
2. Description of Work
r_. 4. Arch itect/Designer's Name La st
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Architect/Designers Address
Architect/Designer's E-mail Address
New/Added Sq Ft
Extg Sq Ft 0_j L Total Sq Ft 09
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Valuation $
[I New ❑Add F, Alter Demo
# Stories
E
Check Appropriate Box for Applicant/Notification
F1 3. Owner's Name LastFirst
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Owners Address
Owners E-mail Address
City State ZIP
F _7
Telephone[ 711
r_. 4. Arch itect/Designer's Name La st
First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City State ZiP�
- TelephoneF-r
E S. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State Zip
TelephoneF-,
6. Contractor's Name Last Lic. No. Class
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Contractor's Address
Contractor's E-mail Address
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city L op-arw- State F_6�7zip [01 (0 t�- Telephone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $