HomeMy WebLinkAboutF2022-0369 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# Fire Sprinklerre Alarm F-1 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name
2. Description of Work
Extj Sq Ft 1 New/Added Sq Ft Total SqFt
----- ------
New F_ Add F7 Alter F_ Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last First
—7 - - -------- -- ---
Owner's Address Owners E-mail Address
State Telephone city F777 zip F F
Units F
Valuation $
# Stories
4. Architect/Designer's Name Last 1 FirstLic. No.
Architect/Designers Address Architect/Designer's E-mail Address
7
City State F777 zip F_ Telephone
5. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State F—Zip Telephone
F6. Contractor's Name Last First Lic. No.
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Contractor's Address
I co -2 \ 6_ m, __?_V-_Vw
city N�L State
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
Contractor's E-mail Address
zip F4-2-4k 2r- Telephone Fik-`, 5. , —ts -) v-
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $