HomeMy WebLinkAboutF2023-0118 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
Tenant Name S A,P
2. Description of Work
F Fire Sprinkler Fte FireAlarm r Fire Misc
Extg Sq Ft F—
Ne�w/Added Sq Ft F— Total Sq Ft
r New r Add r✓ Alter r Demo
^VV'�V' VA wr MPP11GdnU1V0TITIcauon
Floor Suite No
# Units I —
Use
Valuation $ 3�6
# Stories
r 3. Owner's Name Last
d�
��
-� First �—
Owner's Address
Owner's E-mail Address
City
State
F_
Zip [_ TelephoneF—
I— 4. Architect/Designer's Name
Last ( � Z_6 First Shc � — Lic. No.
57 %TZ )
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State
�—
Zip F_ Telephone[—
F 5. Engineer's Name Last
First F_Lic No.
F_
Engineer's Address
Engineer's E-mail Address
City I
State
F_
Zip [_ TelephoneF—
I— 6. Contractor's Name Last
First F Lic No. F Class F—
Contractor's Address
Contractor's E-mail Address
City �—
State
F—
Zip F TelephoneF_
OFFICE USE ONLY
PERMIT NO. —D�
TYPE OF CONSTRUCTION
PLAN CHECK NO. G Dy�'D��o
OCCUPANCY - GROUP
PLAN CHECK FEE $