HomeMy WebLinkAboutF2022-0440 - Permit ApplicationPlease print3 copies
Associated Building Permit #
1, Proiect Arl.im :f
P
Worksheet for Fire Permit A ppticatio
Z City of Newport Beach - Building 13ivision
Z
1�+ Fire Sprirtlder [°j Fire Alarm ] Fire Wsc
TenantName .._....__i%•j' t�v_� �:
2. Descr4*on of work
7a Dg377 AA SgJ4ev " in 1: r .
Floor Suite No
Z
S *Units
Extg Sq Ft New/Added Sq. Ft F ,Total Sq Ft.
n New r Add Alter ❑ Demo
Check Appropriate Box for
Use - -- -I
Valuation $
# Stories
3.Owner's Name LastFirst
Owner's Address Owner's E-mail Address..
it/ 1,5fiat zO�r
City L.-_-- N'�%�--r%Gc-.State F1'�9-f ZiP.F-�`L�f TelePhone[ ^ ---.--
4.,Architect/Designees Name Last —�
{First �(�� _ Eic.Na:.
A�mh(it�ec�t/Designer's3ryAddress Amhitect(pesigner's E-mail-Address
City -_Q ice_ State 7 Zip %L/J(/ Telephone
5. Engineer's Name Last First ��� J
Engineer's Address Engineer's:E-mail Address
City'
�— State bP. f Telephone
(- 6. Contractor's Name Last First t_
Lic No:. q.2� L(/ Elass I
Contractor's Address Contractors E-mail Address - {
Cty State F^ ZjPWiF,� r , Telephone
OFFtCE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $