HomeMy WebLinkAboutF2023-0144 - Permit ApplicationWorksheet for Fire Permit Application Please print 3 copies �EW°°T
11
City of Newport Beach - Building Division
Associated Building Permit
X C vZ Z� 2 0 �i Fire Sprinkler r"lre Alarm ri Fire Misc
1. Project Address (Not mailing address)
,) Floor Suite No
lD NON NYC -._ CQ +Mtr w - — _ ! I ' — a 2CSb
Tenant Name 1 #Units I l , F--
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2. Description of Work
Tuse
.
Extg Sq Ft —!
New/Added Sq Ft F Total 5 Ft
Valuation $
[ j New F_ Add
Alter F-' Demo
# Stories
Check Appropriate Box for Applicant/Notification
F_J3. Owner's Name Last 1i� 1!
l I V u _5 First
Owner's Address J
Owner's E-mail Address
--
City State Zip Telephone
f-4. Architect/Designer's Name Last First
- - - _ Lic. No.�.-_-_-_
Architect/DesignersAddress Architect/Designees E-mail Address
City State — -- --
__. --------- ---... .-- - �— Telehone___-
Zip -. p
f- S. Engineer's Name Last - First—
____, Lic No. �—
Engineer's Address Engineer's E-mail Address
City State _ _ - ---
ZiP � Telephone
--;
6. Contractor's Name Last i r, r First' pb j- Class GIQ
Lic. No. .21 f
Contractor's Address Contractor's E-mail Address
2�e_ lJ. lsCt c.il/t�,
City Zip ("t -
State r� — - --
- _- Telephone r-
1 C40�D
OFFICE USE ONLY PERMIT NO. [ f
TYPE OF CONSTRUCTION PLAN CHECK NO. �zeiZ/� — Q -7
OCCUPANCY -GROUP �7
C �ZZ -QZj 6 PLAN CHECK FEE $