HomeMy WebLinkAboutF2022-0526 - Permit ApplicationWorksheet for Fire Permit Application oF�Ew`°Rm
City of Newport Beach - Building Division G
Please print 3 copies G��Foar"
Associated Building Permit # n Fire Sprinkler A' Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor tIeNo- ----
Tenant Name u{Z ACart A$y #Units
2. Description of Work
Extg Sci Ft —� New/Added Sq Ft F Total Sq Ft F-11
ri New r Add r, Alter r. Demo
Check Appropriate Box for Applicant/Notification
Use
Valuation $ )i3
# Stories
( 3.Owner's Name Last uZ IA % Fi st,
Y - -
Owner's Address Owner's E-mail Address
City �� State I Zip qY& P Telephoner
`
4. Arch itectlDesigner's Name Last I First Lic. No.
-' - -- — - -
Architect/Designers Address Architect/Designer's E-mail Address
city State Zi Telephones:
�_. ----. __ pF I _
r' 5. Engineer's Name Last First f Lic. No.
P90�
D
Engineer's Address Engineers E-mail Address
--
City bG State Zip l Telephone v 3i%C;-
/
w®�
ri6. Contractor's Name Last _ d� j>(� RIA,( st�—, Lic No. � Class —'
I ' {
Contractor's Address Contractors E-mail Address
city State F__ Zip F---, Telephone--
/
OFFICE USE ONLY PERMIT NO.
PC�o1� ZSZI
TYPE OF CONSTRUCTION — PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $