HomeMy WebLinkAboutF2023-0397 - Permit ApplicationPrint Form
Please print 3 copies
Accnciated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
Tenant Name /` k v Et
2. Description of Work
r Fire Sprinkler Fire Alarm
rl i AVRI4 Vi "'I
Extg Sq Ft NewlAdded Sq Ft F— Total Sq Ft
F- New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
first
r 3. owner's Name Last � tiizVl ��"lp
Owner's E-mail Address
r Fire Misc
Floor �UILC
Ir
P I 3
# Units F
Use F
t1J� ``.ems
Valuation $ j
# Stories II
Owner's Address
���'"I' ��C( State i� Zip "I � e� Telephone —
City %%f%
Lic. No.
F_4. Architect/Designer's Name Last
First F— �—
Architect/Designers E-mail Address
Architect/Designer's Address
�—�— City State F— zip �— TelephoneF�
(— 5. Engineer's Name Last
_f7k_y4r� First l�l� Lic No. 177 y1�r:
Engineer's E-mail Address
Engineer's Address
State (i� Zip � i � (/ Telephone q (/q, )?t/.g_ I ��
City �
First
Lic No. F— ClassF—
r 6. Contractor's Name Last `r(f �i� ��� ll✓
Contractor's Address
City
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
Contractor's E-mail Address
State F— zip F— TelephoneF�
PERMIT NO. C vZ3' o3g7
PLAN CHECK NO.
PLAN CHECK FEE $—�