HomeMy WebLinkAboutF2022-0540 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mail
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Tenant Name L
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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address)
-34 j Fire Sprinkler ❑ Fire Alarm
CO l��S JL- bt14'tj3� tv+�
Extg Sq Ft F771 New/Added Sq Ft Total Sq Ft
ew ❑ Add ❑ Alter ❑ Demo
US
re Misc
Floor Suite No
I F -7 �77
# Units I
Use
Valuation
#Stories 171
Check Appropriate Box for Applicant/Notification
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❑ 3. Owner's Name Last ���-------��—
First
Owner's Address Owner's E-mail Address
i
City State Zip Telephoned
❑ 4. Arphitect/Designer's Name
Last First
Architectlobsigner's Address
city State C J
Lic. No.
Architect/Designer's E-mail Address
Zip Telephone
❑ 5. Engineer's Name Last First
' Lic. No. � J
Engineer's Address
Engineer's E-mail Address
city I State Zip Tefephone�
- � �JJJ
Contractor's Name
Last
�1-ul.C/ First �.G`sL,� Lic. No. Class FLam,,
Contractor's Address
City �Q State
OFFICE USE ONLY
TYPE OF CONSTRUCTION
Contractor's E-mail Address
4JoF f+l�Ul�gt�taoaLa�n off, G�1Nt Q (c/✓1
Zip L Telephone A,
PERMIT NO. _ :-Z,,� — 05 C/O
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $