HomeMy WebLinkAboutF2022-0188 - Permit ApplicationWorksheet for Fire Permit Application o��`. H@
Prinf Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # (gl Fire Sprinkler [—I Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
14,35ANT/AC10 p12-1Ve-- F_ 7
# Units
Tenant Name
_ _ _ _ _ _ —J
J
2. Description of Work
Use REsI P-EluT1AL-
p0SI(:7N BxAIW A NEW a - S-lb?-y pVEV_KrEAD P-eSCDt!N1-14l
f__LLt�----- S1'RINK�R S�S�M w �N'�_S�Ri�tt �pDS �
Valuation $
Extg Sq Ft
J New/Added Sq Ft �r 3-- J Total Sq Ft -4 3
-- J
_
# Stories
I7� New ❑ Add ❑i Alter ❑ Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last y2l�pr/.!T J First
Owner's Address Owner's E-mail Address
1�31P SPrNTkAC-1D P(ZIVC
City State Zip Zlo 6 b j Telephone q H q iD $9 ' OZ 2
4. Arch itect/Designer's Name Last _ J First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F zip�; Telephone
�I
❑ 5. Engineer's Name Last J First � Lic. No.
Engineer's Address Engineer's E-mail Address
I i
i
City State I Zip Telephone
16. Contractor's Name Last V U First A be Lic. No. 103 8 3 9iclass C ^ � 6
------------._-. _._----- --�------------- - ------J -------
Contractor's Address Contractor's E-mail Address
--a 6 21 W- S_UM�( -
----- -- --- i ��e vp�ec�ior des K e
- rya, I -caw►
- - - - - - -- ..--- 5 -- -- -- - ---
City A NA R E / M -- State CA Zip Z. C) Z- 1 Telephone �51L33
OFFICE USE ONLY O PERMIT NO. 2Zo lqr
TYPE OF CONSTRUCTION PLAN CHECK NO. �✓
2
OCCUPANCY - GROUP 20 �j PLAN CHECK FEE $
P