HomeMy WebLinkAboutF2022-0638 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies r ITO
Associated Building Permit # x� ��2 -�� ! F_ Fire Sprinkler Fire Alarm F7 Fire Misc
1. Project Address (Not mailing address) r Floor Suite No
Tenant Name L #Units
2.
Description
- ��- D-escr-ip-t-ion- o-f--Work
fl AUM- -- ------j�t�-- r�Use
- - -
Extg Sq Ft New/Added Sq Ft Total Sq Ft �� � � Valuation $ �LiG7(�o
# Stories t
. New r Add Alter r Demo _!
Check Appropriate Box for Applicant/Notification
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F 3. Owner's Name
Last First
Owner's Address
Ow is E-mail Address
i
City
State �— Zip F TelephoneI--
F_ 4. Architect/Designer's Name
Last First Lic. No. ,
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip �— Telephone,
r— 5. Engineer's Name
Last �— First Lic. No. F__�__
Engineer's Address
Engineer's E-mail Address
i
City
State Zip Telephone (—�
i. Contractor's Name Last +`; First Lic. No. '7Z� ® ass�—
Contractor's Address
Contractor's E-mail Address
City
- State �— Zipj 7 (� Telephone 0? r—
OFFICE USE ONLY
PERMIT NO.Z2
TYPE OF CONSTRUCTION
PLAN CHECK NO. FC�,vZ
OCCUPANCY -GROUP
PLAN CHECK FEE $
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