HomeMy WebLinkAboutF2022-0350 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies City of Newport Beach -Building Division f to v - 6o - , Print Form u4,,.
Associated Building Permit# Fire Sprinkler F_j Fire Alarm F—, Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name . _U/ELL- pf-z # Units
2. Description of Work
MPR
Use
I _10--E-4 -t-0
Valuation $
Extg Sq Ft New/ dded Sq Ft Total Sq Ft
t—NIL New f--L-Add F_,11 Alter F-1 Demo
# Stories
Check Appropriate Box for Applicant/Notification
-Informatffou
F 3. Owner's Name Last First F
Owner's Address Owner's E-mail Address
City State Zip Telephone
F-] 4. Architect/Designer's Name Last First Lic. No. F 7
Architect/Designer's Address Architect/Designer's E-mail Address
City State zip Telephone [ I I
r—] 5. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State zip telephone
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6. Contractor's Name Last 166L,,j First Lic. No. Class Contractor's Address Contractor's E-mail Address
City -•" - �. -State
R-TZip Telephon
-7 F I
OFFICE USE ONLY PERMIT No.
TYPE OF CONSTRUCTION PLAN CHECK NO. 6 OVA Z_
OCCUPANCY - GROUP h��PLAN CHECK FEE $
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