HomeMy WebLinkAboutF2022-0217 - Permit ApplicationLl bt,IC.es Worksheet for Fire Permit Application
City of Newport Beach - Building Division o
Please print 3 copies
Associated Building Permit #`� [I Fire Sprinkler JIV., Fire Alarm /[+ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
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GJIr�S� L to --- . � 7
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Tenant Name
Name Last—�First—, Lic. No.—,
# Units ��
2. Description of Work
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Extg Sq Ft C
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New/Added Sq Ft Total Sq Ft L
Valuation $ z �
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Engineer's E-mail Address
146
City �e� Y1 _
New [ Add [
Alter [ Demo
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Contractor's Address
Contractor's E-mail Address
Check Appropriate Box for Applicant/Notification
[ 3. Owner's Name
Last— - First F77777
Owner's Address
Owner's E-mail Address
State Zip Telephone
4. Architect/Designer's
Name Last—�First—, Lic. No.—,
Architect/Designer's Address
Architect/Designer's E-mail Address
City I —
_ - State —, Zip F —, Telephone-
[ 5. Engineer's Name
Last aZGL FirstIatsn lG� l— Lic. No.
I
Engineer's Address
Engineer's E-mail Address
146
City �e� Y1 _
— State �— ZipJ Telephone
[6. Contractor's Name
Last -I First—', Lic. No.l�p�3o�✓Cla'ss G�
Contractor's Address
Contractor's E-mail Address
------
City
State Zip Telephone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.�
OCCUPANCY - GROUP
, CD PLAN CHECK FEE $