HomeMy WebLinkAboutF2022-0113 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print}.copies
Associated Building Permit # F-, Fire Sprinkler
1. Project Address (Not mailing address)
Tenant Name
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G(IRORYJ
Fire Alarm (-` Fire Misc
Floor
Suite No
# Units
2. Descnptron o or
Use I3
rN D
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Valuation $ Ci
Extg Sq Ft New/Added Sq Ft Total Sq Ft
# Stories
❑ New ❑ Add ❑ Alter ❑ Demo
Check Appropriate Box for Applicant/Notification
❑ 3.Owner's Name - Lasts �� ��p� rstI
Owner's Address Ownel/r's E-mail Address
C i ' Al 4�7a>,! I
City w_) s State Zip 0-1 Telephone
(- 4. Architect/Designer's Name Last First'', Lic. No.0
Architect/Designer's Address Architect/Designers E-mail Address
6 _ _
city J State Zip 171 Telephoned,--
❑ 5. Engineer's Name Last s � ; First tG Lic No.
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Engineer's Address - Engineer's E-mail Address
City �U" �j--`Mate Zip '�1 7 G1 LYr/; Telephone
G 6. Contractor's Name Last ld t�� Lic No. Class
---- --
Contractors Address Contractor's E-mail Address
city !I State L Zip Telephone
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OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $