HomeMy WebLinkAboutF2022-0153 - Permit Application�20Z2-D15
Worksheet for Fire Permit Application o�`W
City of Newport Beach - Building Division
Associated Building Permit# I a/ 3L1 Z7I/Fire Sprinkler r Fire Alarm F'Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2541 Eas�bluF Dc;ve. , 1�le��or_ GFS f 2 __
I
Tenant Name y�x _ # Units
2. Description of Work
Use
AAd $ irekcca to new QR
City �-.. -...
Valuation $ "1I
1,,,.---
Exfg Sq Ft New/Added Sq Ft r Total Sq Pt 841
--
Architect/Designer's Address
#Stories
(-" New f—', Add r: Alter f --Demo
State 2,.., Zip F Telephone
Check Appropriate Box for Applicant/Notification
Ir.4....w..4iw..
f, 3.Owners Name Last
First
Owner's Address
Owner's E-mail Address
City �-.. -...
State r,, zip [—'. Telephoned
f— 4. Architect/Designer's Name Last
T First Lic. No.
2
Architect/Designer's Address
Architect/Designer's E-mail Address
city
State 2,.., Zip F Telephone
r 5. Engineer's Name Last
First [ Lie. No.
Engineer's Address
Engineer's E-mail Address
city �..� _
State Zip Zip C Telephone
6. Contractors Name Last E6AL$ FirstLic.No f 1D17(pwl Class CI(A�
22 l..__..
Contractor's Address
Contractor's E-mail Address
22145 Lg Palrr)ct hj __
WyleaaQSh21.}DniiCe,.�prvn._.._..
City OriJA (A rl0lfq .--_-- ','
State �( L. Zip Ci2$S%' Telephone,.jt{'-
OFFICE USE ONLY
PERMITNO. —
TYPE OF CONSTRUCTION
PLAN CHECK NO. O7 53
OCCUPANCY- GROUP
PLAN CHECK FEE $
222 - l 2