HomeMy WebLinkAboutF2022-0553 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies City of Newport Beach - Building Division
Associated Building Permit# jV Fire Sprinkler rlFireAlarm
-- ____. _.- [ Fire Mix
1
Project Address (Not mailing address)
Tenant Name IAw't✓ i2
2. Description of Work
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Ectgg Sq Ft New/Added Sq Ft —! Total Sq Ft F77—'
E i New [` Add V Alter F_ Demo
Check Appropriate Box for Applicant/Notification
F�l"odor—
L --_
Suite No
# Units
Use
Valuation $
# Stories F
F7 3.Owner's Name Last First 1�r1
Owner's Address Owners E-mail Address
city ,w fl-.,� - State �— �— Telephone
T 3 e�g_c,�_ C".IA Zip
F 4. Architect/Designer's Name Last First F—
Lic. No. �—
Architect/Designers Address Architect/Designer's E-mail Address
City
State i Zip Telephone
En Engineer's Name Last FirstF —
Lic No. �—
Engineers Address Engineers E-mail Address
City - _ _ --.. -- State Zip
- F— Telephone
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(-6.Contractor's Name Last G",Qr -u� First\—
r]YleYL Lic No. �7�Y! Class L'_{�
Contractors Address Contractor's E-mail Address
i 2
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City 1�IPM.P_a State �—
Zip . Tele p - - -
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OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK NO - e,'
PLAN CHECK FEE $