HomeMy WebLinkAboutF2023-0233 - Permit ApplicationPrint Fonn Worksheet for Fire Permit Application o26WPpRm
City of Newport Beach - Building Division
Please print 3 copies �;
Associated Building Permit#
r Fire Sprinkler r Fire Alarm ,Fire Misc
1. Project Address (Not mailing address) Floor Suite No
72J r—
Tenant Name I + of 0. S eL i Vt 5 # Units �-
2. Description of Work
i S %cN %IL 30o S' S'� 5 — -
Use
Extg Sq Ft F-- New/Added Sq Ft F— Total Sq Ft F_
Valuation$ y
New r Add r Alter r Demo
# Stories I
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last First 7—
Owner's Address
Owner's E-mail Address
City I
State �— Zip �— Telephone—
r 4. ArchitectlDesigner's Name
Last First F Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State F_— Zip F— TelephoneF—
f— 5. Engineer's Name
Last First Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City
State Zip F TelephoneF_
6. Contractor's Name Last J Y First FP &Tet,T Lic No. ;5, 311- Class F76
c%
Contractor's Address
Contractor's E-mail Address
133aIZZI�,tGf-(edriC-KF'verrd+ec
City G� , r o
State �— Zip (7 / 0 Telephone �'�
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.90-2/6✓ ^ Z / Za
OCCUPANCY- GROUP
PLAN CHECK FEE $