HomeMy WebLinkAboutF2023-0115 - Permit ApplicationWorksheet for Fire Permit Application o, °
City of Newport Beach - Building Division
Please print 3 copies aFop
Associated Building Permit '
9 Fire Sprinkler F-1 Fire Alarm ri Fire Misc
1. Project Address (Not
Tenant Name ..._eA ..--Jr'{.`.-."p_-go _ . _4_.....---
2. Description of Work Z
006
Extg Sq Ft � L - - New/Added Sq Ft Total Sq Ft
[I New [ Add [Alter (-I Demo
yr rccn rANNrUpnMe oox for AppncanU NOtnlcation
Floor Suite No
i
# Units F
Valuation $ 2Z ja 1
# Stories
3.Owner's Name Last
' First F_
Owner's Address
1-77
Owner's E-mail Address
City _---
State —Zip
e— Telephone
F_ 4. Architect/Designer's Name Last
First F— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �—
Zip—: Telephone ---,State
5. Engineer's Name Last
- ---
..---------
First
_ _ ___ Lic. No, e'
Engineer's Address
Engineer's E-mail Address
City
State �—
Zip �— Telephoned---
Contractor's Name Last First r/ Lic. No. FtClass
Contractor's Address
Contractor's E-mail Address
City
State I
Zip f(/P- Telephone(91 I/ ,.`q6( r
OFFICE USE ONLY
Z - D�/i PERMIT NO. SO-1.
TYPE OF CONSTRUCTION _
P12
( PLAN CHECK NO. PLZtTI�?j ' Oq
OCCUPANCY - GROUP
xC�n� Z �� PLAN CHECK FEE$