HomeMy WebLinkAboutXC2023-0239 - Permit Application (3)Print Form Worksheet for Fire Permit Application US,
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # �G 2(]23 02 cl r Fire Sprinkler Wire Alarm r Fire Misc
1. Project Address (Not mailing address)
who N Wt &Vff-V 0�, ,
Tenant Name Z"ck h 6l r coYaY
2. Description of Work
Extg Sq Ft F— New/Added Sq Ft �— Total Sq Ft
I— New i- Add I5D Alter (- Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F,
Use r/ I yl
Valuation$
# Stories
f- 3. Owner's Name Last
J\Q(yy,�A� First
1 '
Owner's Address
U Owner's E-mail Address
City I
State F— Zip F Telephoned---
F_ 4. Architect/Designer's Name
Last First F_ Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip F_ TelephoneF_
r 5. Engineer's Name Last
First F Lic. No. �—
Engineer's Address
Engineer's E-mail Address
city
State F— Zip F— Telephoned
ll
IC6. Contractor's Name Last `�vI�GY First Lic No. fFZq(,� Class G10
Contractor's Address
Contractor's E-mail Address
uVAL" o"
I � r--c-�
City I (IuoAbc 0..
State �— Zip I CA( -7 41 lj Telephone 7Cq -2, -
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. <�
' 07_38 �7-07L T6)6
PLAN CHECK NO.
OCCUPANCY -GROUP
.7 PLAN CHECK FEE $