HomeMy WebLinkAboutF2022-0561 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application (F%lCity of Newport Beach - Building Division
Sprin
kler er � : [ S p ' [Fire Alarm ri Fire Misc
Extg Sq Ft i New/Added Sq Ft j Total Sq Ft
[ New [ Add [ Alter [ Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last— j First,
Owner's Address Owner's E-mail Address
I
City State Zip � Telephone[
Floor Suite No
[
I — Tbn -
#Units Fp0
Valuation $ _fj ovo 71
# Stories
4. Architect/Designer's Name Lasti First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip r Telephoner-
5. Engineer's Name Last lar to �' �s� First l f4 C
Engineer's Address Engineer's E-mail Address
City J9.H�°I.__ �l-�2"t-------- State -� ---- Zip _..72-70I..j Telephone �t�� "3J_ it?p
[6. Contractor's Name Last .AVrY. �'�� SYS - - First Lic No. F7j27v-,Class
Contractor's Address Contractor's E-mail Address
City S-z! A � t State ��A�-__.... Zip .__ �� 7Oe( Telephone �Y5'—.3.5
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK FEE $
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