HomeMy WebLinkAboutF2022-0145 - Permit Application (2)Print Form
Please print 3 copies
Associated Building Permit#
F--Z02-;z--01U6
Worksheet for Fire Permit Application airCity of Newport Beach - Building Division
1. Project Address (Not mailing address)
2. Description of Work
Fire Sprinkler ❑Fire Alarm r Fire Misc
Extg Sq Ft �, New/Added Sq Ft �'Total Sq Ft
r New Add n Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor
Suite No
77
snits
Use
Valuation $ 2 �V v
{ --
# Stories F7
r 3.Owner's Name Last u l�
' FirstV/
Owner's Address
Owner's E-mail Address
City',,' State
�. Zip [7777 Telephonel
j 4. Architect/Designer's Name Last /' n r `� First S� �j�/e Lic. No. oi5g4
`-� V'
Architect/Designer's Address
Architect/Designers E-mail Address C
ioeax_av Cal
city —�-. State
Zip Telephone
I
n 5. Engineer's Name Last
F`irsst�F777777 Lic. No
Engineers Address
Engineer's E-mail Address
i
City - State
F777 Telephone
Nq, `7�j�{� a^
Last S ep w Vvl-w-'(Lnrsttractorr
CostractortsAddreshame
ConE-mailAddress
336,41 ( atbe P-�'ir <l e* -
- - S � ! �� f �U�I Pie (��J.C6/ 04-1 .
City , ua✓-->r_ ,�, l-.�r/J�1.�tate
J`��/'d
Telephone
-�— Zip Telephone
i
OFFICE USE ONLY
PERMITNO.
a ZZ
TYPE OF CONSTRUCTION —
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
PZ022-G134