HomeMy WebLinkAboutF2023-0088 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit Fire Sprinkler F-1 Fire Alarm [I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name � JF61� # Units F
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2. Description of Work
F
_--Use
- - -
Extg Sq Ft ! New/Added Scl Ft — Total Sq Ft
Valuation $ en,
�I New (-•_ Add [ Alter �I Demo
# Stories
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last _ �p�� ;+ First- ,
Owner's AddressOwner's E-mail Address
J9Y
City I /L,, rC EState—' Zip Telephone
94. Architect/Designer's Name Last C;� First Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
Ci // �� �,/ �� // StateZi h
tY /� p �a�3�jj Telephone
%5. Engineer's Name Last n�n�First
1Y��cfE — --- �L - Lic No. F
Engineer's Address Engineer's E-mail Address II
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City State �j Zip j 3 Telephone
r' 6. Con/t-r�acctto-r's Name Last � �o� - First �G�ic. No. - Q Class 41
Contractors Address Contractor's E-mail Address
city State Ft ` - Zip q� Telephone -TI`7 l
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $