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HomeMy WebLinkAboutF2022-0080 - Permit ApplicationWorksheet for Fire Permit Application Please print 3 copies a'�" Print Form City of Newport Beach - Building Division o PUTT—pp W cu ow^`' Associated Building Permit # —_ ! i Fire Sprinkler ❑ Fiffi Alarm [ Fire Misc 1. Protect Address Tenant Name 2. Description of Work Extg Sq Ft [ New/Added Sq Ft Total Sq Ft F ❑ New [7, Add ❑Alter ❑ Demo Check Appropriate Box for Applicant/Notification Floor Suite No F5 l 1 # Units FI Use _6 Valuation$ [moa L-__ ___ __.J a # Stories ❑ 3. Owner's Name Last ( ✓" Z F Owner's Address Owner's E-mail Address lA©.-� V t 0V C-'`�r-P�-_ Ott. , ,3-0 _ --- --II _ City �1 t!� -Be��G State Zip Telephone 2Z�f C9' �' °�Zhle— 57� 6U- ❑ 4. Architect/Designees Name Last - FirstLic. No. Architect/Designer's Address Architect/Designer's E-mail Address ---- - --------- - -- - -- ---- -- - J - -- -- . - ..___. ---- ------ _. City -- - State -JI ZipF77771 TelephonerI ❑ 5. Engineer's Name Last J� y - hq.!v jotFirst (� Lic. No. i 3 Engineer's Address Engineer's E-mail Address �— ,g - city ��C�(LV l ���_ State - -- ------ ]I Zip F7777 Telephoned ❑I 6. Contractor's Name Last J4 (L - F ) First Lic. No. Class "/ 61 Contractor's Address Contractor's E-mail Address ���1 �eV�iwu��✓' l � - �Ct�1n,r,� ¢' Cealwo�Ye, ci✓Ic.. -----J City oc-e L� d,�._ - FTII-i' b_C�d-,�-- State Zip_�IZC�SU Telephoneqs �� Z OFFICE USE ONLY PERMIT NO. ffO72, 003V TYPE OF CONSTRUCTION 102-1 ?,i4le PLAN CHECK NO3a ,Goa— OCCUPANCY - GROUP PLAN CHECK FEE $