HomeMy WebLinkAboutF2023-0221 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r— Fire Misc
1. Project Address (Not mailing address)
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Tenant Name S,prG •s";,te _��00
2. Description of Work
Extg Sq Ft �— New/Added Sq Ft �— Total Sq Ft �—
r New r Add r Alter r Demo
t;necK Appropriate Box for Applicant/Notification
Floor Suite No
F- 3z�
# Units I —
Use
Valuation $—
# Stories
I— 3. Owner's Name Last
�—
First �—
Owner's Address
Owner's E-mail Address
City
State F—
Zip �— Telephone
r 4. Architect/Designer's Name
Last
First I Lic. No. --
Architect/Designer's Address
Architect/Designer's E-mail Address
city I
State F—
Zip F_ Telephone—
r 5. Engineer's Name Last
ed
First `;Z,G Lic. No. F_—
Engineer's Address
Engineer's E-mail Address
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City Sr,; vYG
State e
Zip Telephonel—
F 6. Contractor's Name Last
First F_— Lic No. F Class C�
Cro�'nntractor's Address
Contractor's E-mail Address
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City :/'yl • �1 G
State
Zip 7/ V Telephone qyq - 337—, C
OFFICE USE ONLY
PERMIT NO. Aa%4;
TYPE OF CONSTRUCTION
PLAN CHECK NO. 423�
OCCUPANCY -GROUP
�I`� l jI`iALAN CHECK FEE $
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