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F2022-0257 - Permit Application
Please print 3 copies Associated Building Permit # 1. Project Address Tenant Name 2. Description of Work Worksheet for Fire Permit Application e�7 City of Newport Beach - Building DivisionatiL \ 20� ©0 G, ❑ Fire Sprinkler [_TfFireAlarm ❑ Fire Misc mailing address) Floor 'l (-� AtAmA Vz Gc �j 2 e�u� Vj ugh owes t Extg Sq Ft New/Added Sq Ft q , Total S Ft i/ ❑ New ❑ Add Alter ❑ Demo Check Appropriate Box for Applicant/Notification lnf^...._a:__ # Units Use 17GT7-14 Valuation $ Suite No # Stories `T ❑ 3. Owner's Name Last I�"'--------�� C�Y•1 First ` J Owner's Address Owner's E-mail Address City State _ Zip Telephoned ❑ 4. Architect/Designer's Name Last First Lic. No. ArchitecVDesigner's Address Architect/Designer's E-mail Address r—� f city State I Zip Telephoned ❑ 5. Engineer's Name Last First Engineer's Address Lic. No. Engineer's E-mail Address City State ' r --- Zip Telephonel � ❑ 6. Contractor's Name Last c. No. —J hY First Lic. No. 7Z��)L Class T-0 Contractor's Address n Z le l.0 Contractor's E-mail Address U city wa i Statel or ° b�. AC ,�t q JC Zip(, Telephone USE TYPE Z6� PERMIT NO. �— • b252 TYPE OF CONSTRUCTION � � g ` OCCUPANCY -GROUP 2 PLAN CHECK NO. ,JVp 20Z PLAN CHECK FEE $ --�_