HomeMy WebLinkAboutF2022-0627 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler F7 Fire Alarm F Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
3Gl VIA 1,1120 ��b
Tenant Name # Units
2. Description of Work
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Extg Sq Ft F', New/Added Sq Ft—, Total Sq Ft 2J �j(�-----
Valuation $
[ New r Add Alter j- Demo
# Stories I
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Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last First
Owners Address
Owner's E-mail Address
City
- � State �— Zip Telephoned
4. Architect/Designer's Name Last oUhl l First w-C-1 Lic. No. 7t 6 5 5g
Architect/Designers Address
Architect/Designer's E-mail Address
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-- State I�A Zip j :3 Telephone. j�)-,_(ol-I-7- (,l Co ( -- ---- -- ---
F_ 5. Engineer's Name Last First I
'-- Lic No. e--
Engineer's Address
Engineer's E-mail Address
City
State F— Zip—. Telephone
F 6. Contractor's Name Last
(aH � First IZ- Lic No. 7165 $`b Class C-)L
Contractor's Address
Contractor's E-mail Address
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city
State State F Zip �jZ(y-�:, Telephone S�-I�u'l
OFFICE USE ONLY
PERMIT NO. b 0
TYPE OF CONSTRUCTION
PLAN CHECK NO. f IiI.OY1G1jl_� .
OCCUPANCY - GROUP
A PLAN CHECK FEE $
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