HomeMy WebLinkAboutF2021-0156 - Permit ApplicationWorksheet for Fire Permit Application
Print Form p
— City of Newport Beach -Building Division o
Please print 3 copies
Associated Building Permit#
F_ Fire SprinklerFire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
�10 N�w�per} Cenci^ br. F IF
Tenant Name QI�MJS a/_.�y.�L �'�� #Units F
I 1
2. Description of Work
Use r .. .
dire AICArr" 9-jstern AcJitiorA - n w d>zvi(s
Valuation $ S7 Li fi0
Extg Sq Ft q ''� w ✓C New/Added Sq Ft Total Sq Ft
..
—'
# Stories
(
r New (— Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Informatmon
ri 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City � �
State F_ Zip
F Telephoned
4. Archite Designer's Name
L st First F Lic. No.
ArchitecVDe igner's Address
Architect/ Designer's E-mail Address
City
State F Zip
F Telephoned
5. Engineer's Name Last
First Lic.No. F_
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip
F_ Telephoned
F_ 6. Contractor's Name Last vUsgt.)e
First FAlex Lic.No. F4 -i-)Class
Contractor's Address
Contractor's E-mail Address
ILASI Edlogor Ave
ovgC vo,ZL+r )!;1S+trns.60rn
City FvvShn
State 5GA Zip
61)-)(ip Telephone h0q Jclj.elL1Zq
OFFICE USE ONLY
,`02-It UJA� PERMIT NO.
' G c
TYPE OF CONSTRUCTION
jV
PLAN CHECK NO.
OCCUPANCY - GROUPj
PLAN CHECK FEE $