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HomeMy WebLinkAboutF2022-0035 - Permit ApplicationPrint Form Worksheet for Fire Permit Application City of Newport Beach - Building Division Please print 3 copies Associated Building Permit # '� Fire Sprinkler j— Fire Alarm r Fire Misc 1. Project Address (Not mailing address) Floor Suite No J I Tenant Name c � � N Units F— 2. Description of Work �,- IN,21L^r C Extg Sq Ft F New/Added Sq Ft �— Total r New r Add r Alter r Demo Check Appropriate Box for ApplicanVNotif!cation .q Ft 1%Z / Q 0 Use Valuation $ L k Stories ( 3. owner's Name Last I First Owner's Address Owner's E-mail Address pe2>;E—J � Oe— CilyFTU r1ffbJKT fKE19_ 'VJ State Zip q��(�� Telephone[ I— 4. Architect/Designer's Name Last First F Lic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address City — State �— Zip r_ Telephone —g J7 5. Engineer's Name Last I d 414 �lC� } �=j� First 7" Lic. No.71/(4'gj Engineer s Address Engineer's E-mail Address C" ( �%q ©%I Lit �cc G�i7 1� �c�I: �� v i,(� . ✓6 C City I t :_ State �� Zip I ZD7I Telephone �jq -�/F'e;Z(',D W6. Contractor's Name Last 5J0I)&7_ UG First Lic. No.Class Contractor's Contractor's Address Contractor's E-mail dress -71 , I /7�`-' �IVt.0 rld City Stale (Oa' ZiP g'z ( 7� Telephone (& OFFICE USE ONLY l yl n ,� PERMIT NO. 2UtiZl d� 3 TYPE OF CONSTRUCTION y U PLAN CHECK NO. OCCUPANCY - GROUP (l PLAN CHECK FEE $ vv