HomeMy WebLinkAboutF2023-0253 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler ire Alarm r Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
Extg Sq Ft New/Added Sq Ft F Total Sq Ft
F_ New F_ Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Use
U11
Floor Suite No
# Units F
Valuation $ �—
# Stories F
r 3.Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City I
State F_
Zip F_ Telephoned
r 4. Architect/Designer's Name
Last
First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—
Zip F__ Telephoned
r- 5. Engineer's Name Last
First Lic No.
Engineer's Address
Engineer's E-mail Address
City
State I
Zip F_ TelephoneFI
r `(� 6. Contractor's Name Last ���nl�le.�Cta \ First 6 Al} ic.No. )o65 LOLA Class L\Q
Contractor's Address
Contractor's E-mail Address
City �{ gyp\
State
Zip � 2� US Telephone 1 I L (� g\ 3
OFFICE USE ONLY
PERMIT NO. ���� _U ZS3
TYPE OF CONSTRUCTION
PLAN CHECK NO. 9LC L3 -
OCCUPANCY - GROUP
PLAN CHECK FEE $