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HomeMy WebLinkAboutXC2023-0340 - 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) 5� lVPw12w, cPwk-r u,,,,Vt-_ Tenant Name UPi©It i co, tS ev,/c, 2. Description of Work l2elocty-f (I-) r Fire Sprinkler r Fire Alarm r Fire Misc Extg Sq Ft (p i New/Added Sq Ft Total Sq Ft r New r Add '^ Alter r Demo Check Appropriate Box for Applicant/Notification Floor Suite No # Units Use ( /' IP7'CAein /'r fe Valuation $ Sr�� # Stories I ' 7 3. Owner's Name Last First Owner's Address Owner's E-mail Address City � State F_ Zip F— Telephoned_ I-- 4. Architect/Designer's Name Last First r Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City I State F— Zip F_ TelephoneF_ [— 5. Engineer's Name Last First F Lic. No. F_ Engineer's Address Engineer's E-mail Address - City State �— Zip F_ Telephoned F_ 6. Contractor's Name Last Cord First F00A,'e 1 Lic No. S Class CI /i Contractor's Address Contractor's E-mail Address (4 a (aTPPr 5 F• ma"', ftf-,a✓7LQgo f. ('pM City a wq Y cr } State Zip (o�lv �S Telephone 7/4 - 3,,, o14 OFFICE USE ONLY 7�L� 1y� � ` PERMIT NO. TYPE OF CONSTRUCTION / + PLAN CHECK N0. ` OCCUPANCY - GROUP PLAN CHECK E1y_--t