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HomeMy WebLinkAboutF2022-0162 - Permit ApplicationWorksheet for Fire Permit Application City of Newport Beach -Building Division Please print 3 copies f //� 0�/ i Ol (pop Associated Building Permit# I Fire Sprinkler r Fire Alarm rl Fire Misc 1. Project Address (Not mailing address) Floor Suite No _-- - 710 �475 �4 c: /Neza• iw _�'.4r� e,.., A' ca! �— I Tenant Name # Units 1 3 I 2. Description of Work Use % A�-ii4vlfr %n/S /la bn aP Extg Sq Ft New/Added Sq Ft Total Sq Ft Valuation $ 7 pp�j, �' Js� New 7 Add F_ Alter F,_ Demo #Stories F Check Appropriate Box for Applicant%Notification F 3. Owner's Name Last j First— Owner's Address Owners E-mail Address I CiTy State — Zip Telephoned I�� rl4.Architect/Designer'sName Last First Lic. No. Architect/Designers Address Architect/Designees E-mail Address City- _--_ --_ -------_._., State Zip-., Telephoned'.. [' 5. Engineer's Name Last First Lic No. Engineer's Address. Engineer's E-mail Address City State � Zip F— Telephoned �6. Contractor's Name Last . ��A First jvl I Lic. No. �— [ 5Sf (Is Class C-!lo L Con,trractor's Address Contractor's E-mail Address t.i> M ' /. City f�St 2l,�� c State I Zip Telephone g�q 228 - 11961 OFFICE USE ONLY TYPE OF CONSTRUCTION PERMIT NO. �% /I'2 ` PLAN CHECK NCO • OCCUPANCY - GROUP PLAN CHECK FEE $ / ' M