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HomeMy WebLinkAboutF2022-0541 - Permit ApplicationWorksheet for Fire Permit Application US, PnntForm {_City of Newport Beach -Building Division.�y� I ,�Please print3copies r /,Ozb--�Li ( Associated Building Permit# xC [1�J �Z ` 6 [/Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc 1. Project Address (Not mailing address) Floor Suite No 11009 Nay- ��� j &Tch � ©© ��r Tenant Name # Units 2. Description of Work— eIaCaLe C,5 ad Cl 3 F?re $Pt`;nklelS Use f Valuation $ �p Extg Sq Ft New/Added Sq Ft Total Sq Ft r ❑ New ❑Add [❑Demo 1 # Stories IAlter I 0. I Check Appropriate Box for Applicant/Notification ❑ 3. Owner's Name Last First Owner's Address Owner's E-mail Address City State Zip F77:7 Telephoned 4. Architect/Designer's Name Last ( First F7771 Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State F77:7 Zip Telephoned ❑ 5. Engineer's Name Last First I— li Lic. No. Engineer's Address Engineer's E-mail Address i City State Zip Telephoned ❑f6. Contractor's Name Last— First r^e 1 Lic. No. 5P ZR-Classl /'_//_' I Contractor's Address Contractor's E-mail Address �� a i cityUAV Li 1 r / �` State Zip Telephone � l of CJ S� OFF/CEUSEONLY PERMITNO. PWL-Z—^ DELI t TYPE OF CONSTRUCTION — i�ZeSli2 CU PLAN CHECK NO. OCCUPANCY - GROUP PLAN CHECK FEE $