HomeMy WebLinkAboutF2023-0602 - 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)
r Fire Sprinkler r Fire Alarm r Fire Misc
1 /-/oD 6J faLVZ
Tenant Name I C-Nctsi Cffsfizcalf 09�'77pScz
2. Description of Work L
Extg Sq Ft I New/Added Sq Ft �— Total Sq Ft F—
I— New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
U S
c�;Fowr�'
Floor Suite No
# Units I
Use 104
Valuation $ C
# Stories
F_ 3.Owner's Name Last
FirstF—
Owner's Address
Owner's E-mail Address
City I
State �` Zip F— TelephoneF_
I— 4. ArchitectIDesigner's Name
Last �— First F— Lic. No.
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City I—
State �— Zip [ Telephone
(— 5. Engineer's Name Last
�— First F Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City
State �— Zip F_ Telephone[—
6. Contractor's Name Last e First 1� Lic. No.� Class FG�
Contractor's Address
Contractor's E-mail Address C t O
City L(i o 0/ J�
State F�— Zip 7U Telephone�
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
�/ �/� '♦
PLAN CHECK NO. PMS'o 014
OCCUPANCY- GROUP
PLAN CHECK FEE $