HomeMy WebLinkAboutF2021-0603 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies f=2 —DW3
Associated Building Permit #Fire Sprinkler (,Fire Alarm ❑Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Lt3_Y_0
Tenant Name Lx—c ai—_ Units
2. Description of Work
4 1 � 40Use
Ev"77-
Extg Sq Ft New/Added SqTotal Sq Ft
Valuation $ � a, —va
New E7. Add F�l Alter F_ Demo
# Stories
Check Appropriate Box for Applicant/Notification
13. Owner's Name Last i First F__7
Owner's Address Owner's E-mail Address
Zip— Telephone
city State F E_
F,l 4. Architect/Designer's Name La st First Lic. No.
Architect/Designers Address Architect/Designees E-mail Address
City State Zip Telephoned
E 5. Engineer's Name Last First Lic. No.
Engineer's Address Engineers E-mail Address
City State Zip �I Telephoner-"
E6. Contractor's Name Last [Apyg___F
First Lic. No. class
Contractors Address Contractor's E-mail Address
City State Zip[ TelephoneD%r7 47— 477
T — -77- - �
OFFICE USE ONLY PERMIT NO. Fu%i -
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $