HomeMy WebLinkAboutX2021-1045 - Permit ApplicationWorkshoot for Fire, Pevrrnit App ication 0
City of Newport Beach - Building Division �\ ,
Please print 3_copies
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Associated Building Permit # �- [ Fire Sprinkler �` Fire Alarm [, Fire Misc
1. Project Address (Not mailing address)
Tenant Name>
2. Description of Work
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Extg Sq Ft I New/Added Sq Ft Total Sq Ft ( I
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New E Add [', Alter F- Demo
Chock Appropriate Box for AppliCant/Motification
1-.. S<.-. -L .-
Floor Suite No
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# Units
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Use Q
-71
Valuation $
# Stories F_
[ 3. Owner's Name Last rst
Owner's Address Owner's E-mail Address
City State Zip Telephoned
4. Architect/Designer's Name Last [ First Lic, No.
Architect/Designer's Address Architect/Designer's E-mail Address
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City State Zip Telephone
5. Engineer's Name Last First
g t (/ . j Lic. No.F-7-7 I
Engineer's Address Engineer's E-mail Address
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City �jd State F Zip [7 jW Telephone d
[ 6. Contractor's Name Last i TO � t ,1�P�/,qw k /�a,/ s I Lic. No. �j 92g p/ I Class
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Contractor's Address Contractor's E-mail Address
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City State Zip [—� Telephone
OFFICE USE ONLY PERMIT NO. 2otZ Otq
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP PLAN CHECK FEE $ 204 ?S