HomeMy WebLinkAboutF2022-0105 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application's
City of Newport Beach -Building Division c
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7 � ire Sprinkler ❑ Fire Alarm � Fire Misc
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1. Project /Address (Not mailing address) Floor Suite No
2-
Tenant
Tenant Name J(��r0d _ ( P2 ( V4 TCS C. 2
--- - ---- -- --- --- ---
2. Description of Work
ADD �2c �e 7L� SPA1IgL-cz1is 5
Extg Sq Ft New/Added Sq Ft Total Sq Ft
New n Add Ft_o Iter E Demo
Check Appropriate Box for Applicant/Notification
Infw�m�4i�n
# Units
Use
Valuation(� Z
# Stories
F77
3. Owner's Name
Last ;First
Owner's Address
Owner's E-mail Address
Ci ty
State �II ------ - -- - --. - --- - --
Zip [—i Telephoned
F-1 4. Architect/Designer's
Name Last �— First �il Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
StateZip Telephone—
d 5. Engineer's Name
Lasto RN f TV First J a f Lic. No.
Engineer's Address
Engineer's E-mail Address
J�
City
---------------
StateI ii�Cl Zip D r -- Telephone_
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[' 6. Contractor's Name
Last �s�-v�( First Lic. No. y3 ClassI( ',
A" `t , 1
Contractor's-
Address
Contractor's E-mail Address
City
_ State �, Zip F Telephoned
OFFICE USE ONLY PERMIT NO. _r—Z -SZ Z - 0 k 05
TYPE OF CONSTRUCTION PLAN CHECK NO. 05'1"[ l 'Z-LT_Z'Z
OCCUPANCY - GROUP e Z 6 (� PLAN CHECK FEE $
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