HomeMy WebLinkAboutF2021-0253 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
Uct�ort', Newp-)4 Cori-, &ii
Tenant Name
2. Description of Work
K Fire Sprinkler I- Fire Alarm r Fire Misc
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1r 11 ff (
.� I�r4:� I, , Sh�rte" 7 ie,!5gch Z eKs �iNS fi�E sp.; Nlc iPi a�G
Extg Sq Ft New/Added Sq Ft Total Sq Ft F
F_ New F_ Add R Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
I
# Units F
Use
Valuation $—
# Stories
r 3.Owner's Name Last 54cd l
First FMIf-W
Owner's Address
Owner's E-mail Address
City State
F
Zip F Telephoned
( 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
Ciry F_ State
F_
Zip F Telephoned
i- 5. Engineer's Name Last
First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City State
F
Zip F Telephone
r 6. Contractor's Name Last I p7,1) F.rO SP..H) en First F_ Lic. No. F1 O(oy0L,Z class G 16
Contractor's Address
Contractor's E-mail Address
1601 W Ora-,yriv� Avc
Ably @c A-rc5Pr: of l( le,% Co w,
City OfANIState
LA
ZIP 9z9t,8 Telephone 71q-(,3N-3clZ3
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. 1
OCCUPANCY- GROUP
PLAN CHECK FEE $ �I
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