HomeMy WebLinkAboutF2023-0319 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# I Fire Sprinkler Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
Floor Suite No
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# Units
Extg Sq Ft New/Added Sq Ft Total Sq Ft 'I
-- L . ...
New J Add rl Alter (_ Demo
Check Appropriate Box for ApplicantlNotification
Use
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Valuation $ 0�
# Stories b
3. Owner's Name Last Ft- - --- -- t �
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Owner's Address (FirstF__
Owner's E-mail Address
city State � c ZIP G] 767 B Telephone i
[; 4. Architect/Designer's Name Last First Lic. No.
ArchitectlDesigner's Address Architect(Designer's E-mail Address
city
_ _------- .-I State �� Zip Telephone I
5. Engineer's Name Last First F Lic. No. j Q
Engineers Address Engineer's E-mail Address
City r-l�J w/ State /' p -7
-- ------------------' �"/� _i Zip[ r I Telephone...' R -
[i 6. Contractor's Name Last Q �� rst Lic. No. Class
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Contractor's Address Contractor's E-mail Address
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City State — ZIP Telephone
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OFFICE USE ONLY PERMIT NO. fZO Z3. 0319
TYPE OF CONSTRUCTION _ PLAN CHECK NO. Km ' I sq6
OCCUPANCY - GROUP PLAN CHECK FEE $