HomeMy WebLinkAboutF2022-0353 - Permit ApplicationPrint Form_j Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # ( Y Fire Sprinkler G Fire Alarm [ Fire Misc
1. Project Address (Not mailing address)
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Tenant Name
2. Description of Work
Extg Sq Ft New/Added Sq Ft 77 Total Sq Ft FITTt7_77111
0 New r7 Add I i Alter n Demo
Check Appropriate Box for Applicant/Notification
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Floor Suite No
# Units
Use
Valuation $ 1 py O�
# Stories l z l
[, 3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City
State Zip �i Telephone[
4. Architect/Designer's Name Last ��h �� �/ First Lic. No. -jt�s�c6
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip � Telephoned
5. Engineer's Name
Last First � Lic. No.
Engineer's Address
Engineer's E-mail Address
City
i
State Zip Telephoned
l- 6. Contractor's Name Last D006R First �� Lic. No. -11555 Class C.-1(��
Contractor's Address
Contractor's E-mail Address
City tJtK
State ) Zip ��o3c> Telephone 5:b01_�14
OFFICE USE ONLY
PERMIT NO. 267.7-"
TYPE OF CONSTRUCTION
PLAN CHECK NO. 4 Z _
OCCUPANCY - GROUP
PLAN CHECK FEE $