HomeMy WebLinkAboutF2023-0299 - Permit ApplicationPrint Form
Worksheet for Fire Permit Application o4?EWPoR.
City of Newport Beach - Building Division
Please print 3 copies M�i'n%2.O 0 5
Associated Building Permit # . O Fire
P�" 3If Sprinkler F- Fire Alarm KFire Misc
1. Project Address (Not mailing address) Floor Suite No
CVA3r y, �— N
Tenant Name I j }}� A2VZNlr (,4 n .4NN # Units
P ✓ W/A
2. Description of Work
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Extg Sq Ft 10,000 New/Added Sq Ft 5y 00,Total Sq Ft iSL 00 b
F— New Add r Alter F— Demo
Check Appropriate Box for Applicant/Notification
Use
Valuations 3 r�0 060
F_3.Owner's Name LastTR✓SN6 (01-f, First CAC I►,�c=,,,,�
Address
Owner's Address -
# Stories
Owner's E-mail Address
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City t%Er✓Qk►T Be^FP State �_ zip �c.(��0 P
q Tele hone �Nq• 3x.O � �'
ArchitecUDesigner's Address
City
5. Engineer's Name
First I Lic. No.
State F_ Zip F_ T,
Last I H_bL""ep
Engineer's Address
Li 115 E. (oW*W j
City E010e' 64ca+f
E-mail
First— Lic No. L iw01
Engineer's E-mail Address
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State �— Zip �jo� p Telephone 6G1. N�.1(fLt`
F 6. Contractor's Name Last ln / First
0 �Gi ✓ �alln� Lic No. 95717 Class
Contractor's Address Contractor's E-mail Address
City ihGtuSgnJ l'a �ri State ��JJ p 7/
f�— Zip %21;6 Telephone / ti0-jzl,3-S��_j-7
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NO. !//Uagq3^0%�gfQtt
PLAN CHECK NO.
PLAN CHECK FEE $
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