HomeMy WebLinkAboutF2023-0102 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler ire Alarm r Fire Misc
1. Project Address (Not mailing address)
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Tenant Name N e[nre _lkl-f,leQlJJi_
2. Description of Work
F ,- f
Extg Sq Ft F New/Added Sq Ft �— Total Sq Ft F—
r New r Add r Alter r Demo
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Floor Suite No
# Units I —
Use
Valuation $ r 3gQ�I
# Stories F
r 3. Owner's Name
Last
First �—
Owner's Address
Owner's E-mail Address
City I
State F—
Zip [_ Telephone—
r 4. ArchitecHDesigner's Name Last
First �— Lic. No. �—
Architect/Designer's Address
ArchitectMesigner's E-mail Address
city
State �!
Zip F Telephone—
r 5. Engineer's Name
Last
First F— Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City �—
State F_
Zip F_ TelephoneF_
XC Contractor's Name Last
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Contractor's Address
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Contractor's E-mail Address y
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City I toy �eAG /
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State 77,1�—
Zip gD�Q$ Telephone
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. Y
OCCUPANCY - GROUP
PLAN CHECK FEE $