HomeMy WebLinkAboutF2022-0356 - Permit ApplicationWorksheet for Fire Permit Application
Print Form
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit#
Fire Sprinkler ❑ Fire Alarm
/ 1
[, Fire Misc
1. Project Address (Not mailing
address)
Floor
Suite No
(A L;do_
Soi
I
�—
0
—
Tenant Name
J
# Units
2. Description of Work
1115AW nW ite
S �;nk 1t,� SySt� t'
Use
Valuation $
Extg Sq Ft
New/Added Sq Ft s� zJ Total Sq Ft 3D 5
# Stories I 7 _
New ri Add Alter ❑Demo
I
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City _
I State F— Zip Telephoned
Fj 4. Architect/Designees Name
Last First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip �l Telephone
5. Engineer's Name
Last First F-77-7 Lic. F77
Engineer's Address
Engineer's E-mail Address
City
I
State r_ Zip—, Telephone
6. Contractor's Name Last D First �� Lic. No. 765kg 1 Class
Contractor's Address
Contractor's E-mail Address
zZb6 LaW6or4-
sy' +
City . L4k-.e State C�` Zip qZ6 jp Telephone gHti-g9'7_ ZSSt
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK Mft
OCCUPANCY - GROUP
PLAN CHECK FETE