HomeMy WebLinkAboutF2022-0033 - Permit ApplicationWorksheet for Fire Permit Application 94,
City of Newport Beach - Building Divicopies-u
Building Permit # �(jZ (— G �, ( );d Fire Sprinkler r Fire Alarm r! Fire Misc
Address
cant Name
2. Description of Work
rAEnt o2�TIAL tzl vzC(�"L �✓�ISC� t �l _ .
Extg Sq Ft �I New/Added Sq Ft F 1 Total Sq Ft 2) i-,
YQ New r—; Add r-' Alter j—,', Demo
Check Appropriate Box for Applicant/Notification
�Fll000r Suite No
# Units
Use '� lc �-.Tvnv_
Valuation$
F-3 I# Stories I T
U
r 3. Owner's Name
Last �—
First
Owner's Address
Owner's E-mail Address
City _
State �—
Zip �— Telephone
j-' 4. Architect/Designer's Name Last
First F Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City _ _
State F
Zip ��, Telephone—
r 5. Engineer's Name
Last
First—, Lic. No.
Engineer's Address
i
..............................
Engineer's E-mail Address
City
. State F
ZipF—, Telephoned—
r,6. Contractor's Name Last u� First 4� Lic. No. s i class t;,-�(�
Contractor's Address
Contractor's E-mail Address
�Z2(o�2 .
City �i M1
State
Zip q�:�0 '.. Telephone (�
OFFICE USE ONLY
PERMIT NO. f Z2Z 0c�33
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
L? —
C)C" l PLAN CHECK FEE $