HomeMy WebLinkAboutX2022-0311 - Permit ApplicationWorksheet for Fire Permit Applica 'on
�nntorm City of Newport Beach - Building Division iuu� Please print 3 copies o"".•
Associated Building Permit # Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
<13S rLt__)
d
F--]
Tenant Name
Or ��
#Units F
II����JJ
2. Description of Work
City
I State Zip Telephoned
❑ 5. Engineer's Name
Last First F7777:7777 Lic. No.
IN A t'2-
t1 JJ
City
Use
txc,:;k v J tom.
Contractor's Address
Valuation $ � G p
Fe
Extg Sq Ft New/Added Scl Ft Total Sq Ft
c> I- - -
❑ New ❑Add
❑Alter ❑Demo 1" ` 11 _ � _ S Ize,
9
1, O Sl,
#Stories III z IIS
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name
Last j First
Owner's Address
Owner's E-mail Address
IDd r,.p c/ ;Ove or -
City V'r CL State Zip L� Telephoned
❑ 4. Architect/Last ( (A2 First Lic. No. G f�
Architect/Designer's Address
Architect/Designees E-mail Address
City
I State Zip Telephoned
❑ 5. Engineer's Name
Last First F7777:7777 Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip E'I Telephoned
❑6.Contractor's Name Last tni� First _N�vt __117 Lic. No. .r6c_Q0__ Class C-16
Contractor's Address
Contractor's E-mail Address
I L( 22.�
c> I- - -
City �� V y
^� State Zip � L(-� Telephone -) Ic4 365 O I c{y
--0141
OFFICE USE ONLY
[� 02�--O�;LsoLf PERMIT NO. X 20Z), - O 311
TYPE OF CONSTRUCTION
PLAN CHECK NO. 13 Sl - 902a.
OCCUPANCY - GROUP
PLAN CHECK FEE $