HomeMy WebLinkAboutF2023-0070 - Permit Application? C_ .J V
Worksheet for Fire Permit Application o4�w°°Rm
City of Newport Beach - Building Division i
Please print 3 copies +��.oa •,
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Associated Building Permit # j i 1 Fire Sprinkler �i Fire Alarm [] Fire Misc
1. Project Address (Not mailing address)
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Tenant Name �— I 0
2. Description of Work
Floor
Suite No
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#Units
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Extg Sq Ft I New/Added Sq Ft Total Sq Ft F�11
�i New r- Add Fi Alter Demo
r�NNrupilatt; ovA Iur,vppn GanTiNotincation
Use - - �ij/ To-r
Valuation $ 2�
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# Stories T'
3.Owner's Name Last I C¢ij7 I First-
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Owner's Address Owners E-mail Address
City ' /
%t� pT®q- 51 State Zip Gli D Telephone
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r 4. Arch itectlDesigner's Name Last I First Lic No.
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ArchitectlDesigners Address Architect/Designer's E-mail Address
city State l Zip F Telephonel
5. Engineer's Name Last ___ �T-1 -__ _- -- No,
En Engineers E-mail AddressLic.
Engineer's Address
City �+ b0( - State Zip y
----p� �-. P q�-(-----' TelePhonel.. ilq-
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(l6. Contractor's Name Last r rat I Lic No. - Class�—
Contractor's Address Contractors E-mail Address
city ,1 State —' Zip F Telephone
OFFICE USE ONLY PERMIT NO.��
TYPE OF CONSTRUCTION PLAN CHECK NO,
OCCUPANCY - GROUP PLAN CHECK FEE $