HomeMy WebLinkAboutF2023-0166 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application orEW�'e
City of Newport Beach - Building Division
oa+`'
Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
/Yain 34i
Y. Drone e
c,► ; 9 2 Z
1 �—
Tenant Name
# Units F
2. Description of Work
Use
7*3 Q Fi'/G
9prr,r Vey- SVS 1 CM
0 FP19
Extg Sq Ft F
New/Added Sq Ft �—
Total Sq Ft
Valuation $ 8/
# Stories F
r New F Add
r Alter (— Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
First F—
Owner's Address
Owner's E-mail Address
City
State
F
Zip F_ Telephone—
r- 4. Architect/Designer's Name
Last
First F Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
F
Zip F_ Telephone—
r 5. Engineer's Name Last
First F— Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City
State
F_
Zip [_ Telephonel—
6. Contractor's Name Last�k�yyah
A
First I N gy.1'X Lic No. 1020yo(.Class
Contractor's Address
Contractor's E-mail Address
S8 Z� Doedql .Dr PagorA
I"341 ireg irep rhai • Cows
City
State
F_—
Zip F_ Telephoned
OFFICE USE ONLY
PERMIT NO. FZo23- Ol�a/o
TYPE OF CONSTRUCTION
PLAN CHECK NO. pcioZ3 -0�3�
OCCUPANCY- GROUP
PLAN CHECK FEE $