HomeMy WebLinkAboutF2021-0028 - Permit ApplicationWorksheet for Fire Permit Application
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City f Newport Beach - Building Division
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Associated Building Permit # �/� ,F_� Fire Sprinkler F, Fire Alarm (7,1 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Namen `�� 4
+V\C� � V #Units
2. Description of Work
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Extg Sq Ft �� New/Added S Ft Valuation $ I `-� (�
,J 9 Total Sq Ft r ---i f./ v
KNew F Add r Alter F Demo I #Stories i F-9—
Check Appropriate Box for Applicant/Notification
13. Owner's Name Laste'� \ — First
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Owner's Address
Owner's E-mail Address
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F-4-Architect/Designer's Name Last i First pv
Y� Lic, No.
ArchitecVDesigner's Address Architect/Designer's E-mail Address
City I /
(! 5. Engineer's Nam/ Last
Engineer's Address
State F —' Zip �i Telephone
First
E-mail Address
Lic. No.
aContractor'sAddr
State ZIP Telephone��(
Last l
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Contractor's E-mail Address
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUPv2U�
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PLAN CHECK NO.
PLAN CHECK FEE $