HomeMy WebLinkAboutF2022-0145 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Division qS a
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Associated Building Permit # Fire Sprinkler [; Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Ccrr't_ Cam --I
Tenant Name # Units
2. Description of Work
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Extg Sq Ft i New/Added Sq Ft Total Sq Ft
New j�,Add [ Alter [ Demo S vi-ella,�
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
I First
Valuation $ I�
0 # Stories F
Owner's Address Owners E-mail Address
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City State 7_71 Zip Telephone[
F-J4.Architect/Designer's Name Last
Lic. No.
Architect/Designers Address Architect/Designer's E-mail Address
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City State Zip Telephone ��f�Q� j j
5. Engineer's Name Last _ First C,
Lic. No. �--�
Engineer's Address Engineer's E-mail Address
City �— State Zip C J Telephone--,
176. Contractor's Name Last
Contractor's Address (Jy I 1 ' (E�
First F Lic. No. �' Class
E-mail Address
City - State �— Zip-, Telephoned -I
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK NO.
K/�� ✓Z —v'7 3 _'2�_AN CHECK FEE $
� 2-0732