HomeMy WebLinkAboutF2022-0648 - Permit ApplicationWorksheet for Fire Permit Application ese print 3 copies «,�oa�" o"`w°°Rem
City of Newport Beach - Building Division � �.�
Associated Building Permit# Fire Sprinkler ;�,'Fire Alarm FireMisc
t. Project Address (Not mailing address) � � - Floor� Suite
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Tenant Named /k( j # Units
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Z. Description of Work III
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Valuation $7 f
Extg Sq Ft F. New/Added Sq Ft Total Sq Ft [ � 1
# Stories �
F[ New I_— Add (!'� Alter [7 Demo
Check Appropriate Box for Applicant/Notification
3.Owner'S Name Last �jZ t �, c0,,� �/ ! First—,
Owner's Address t Owner's E-mail Address
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City A/ poizr t�-OPAM j State � c 1 Zip '�Y� B TelephoneF
4. ArchitectIDesigner's Name Last First— Lic. No.F
Architect/Designees Address Architect/Designees E-mail Address
City State F_ zip Telephone
rl 5. Engineer's Name LastFirst r_ Lic. No.
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Engineer's Address {{ Engineers E-mail Address
City �l �t�) btl" State F Zip 4� 7_IF Telephone I v ` 30 w �J
[7,6. Contractor's Name Last d� p `i-_ - c. o, �31G��� Class�—
f Contractor's Address " Contractors E-mail Address
City,, 1.r \-1an� ----- State r Zip Telephone Put?�O645
OFFICE USE ONLY V PERMIT NO.
TYPE OF CONSTRUCTION — PLAN CHECK NO. !�2017-•3Lt1g
OCCUPANCY - GROUP PLAN CHECK FEE $