HomeMy WebLinkAboutF2023-0423 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Divisio US
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Associated Building Permit # I n Fire Sprinkler Fire Alarm Fire Misc
1. Project Address (Not mailing
Tenant Name
2. Description of Work
Extg Sq Ft F New/Added Sq Ft F___ I Total Sq Ft F
[I New r- Add (—; Alter r Demo
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Floor Suite No
# Units
Use FT/
Valuation $
# Stories
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3.Owner's Name Last Z(i I F.- FirstF-------
Owner s Address Owner's E-mail Address
City A r ff— 5PA State �—, Zip qY(� D Telephone.
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4. Architect/Designer's Name Last First Lic No.�—
Architect/Designers Address Architect/Designers E-mail Address
Cityi State F_ Zip I Telephone-
F_i 5. Engineer's Name Last L� I t S4S IU 1r�/(/• First F Lic. No. �— 1
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Engineer's Address Engineers E-mail Address
City State Zip 7Telephone.._.1 IT
,.`Y 717�
f- 6. Contractor's Name Last `� d� ���JFM�jyrst Lic. No. Class
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Contractors Address Contractors E-mail Address
City State F. Zip —, Telephone
OFFICE USE ONLY PERMIT NO. 1
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $
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