HomeMy WebLinkAboutF2021-0226 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # -- i X Fire Sprinkler j Fire Alarm ('; Fire Misc
1. Project Address (Not mailing address)
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Tenant Name U YJ J I uo
2. Description of Work
-fire 4(ihKl2r 1 i l ►`I) Vu &S
Extg Sq Ft Ll Z 5 i'.! New/Added Sq Ft F Total Sq Ft F
F_ New r' Add Alter F_ Demo
Check Appropriate Box for Applicant/Notification
(9
Floor Suite No
# units F
Use �l►+ai I)
Valuation $
# Stories
r3. Owner's Name Last
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First
Owner's Address
Owner's E-mail Address
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City F krt/I n-e
State �—
Zip R aCf 11. Telephoner
4. Arch itect/Designer's Name
Last �—
First I Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State �—
Zip—'. Telephone
F 5. Engineer's Name Last
_
First Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City _ F—
State F—
Zip [_ TelephoneF——
I>6.Contractor's Name Last
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Contractor's Address
Contractor's E-mail Address
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MhC�If2�F�1S
city I ctV1.1 •'l �
_
State
Zip ga_Jd l Telephone J�. y&,gifa.ex4 �aq
OFFICE USE ONLY
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TYPE OF CONSTRUCTION
J w "-7 PLAN CHECK NO. �•�2�
OCCUPANCY - GROUP
�— PLAN CHECK FEE $
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