HomeMy WebLinkAboutF2023-0449 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler I— Fire Alarm Fire Misc
1. Project Address (Not mailing address)
sz Co,JE
Tenant Name
2. Description of Work
APO L f r1re 5Pr, 0�V--3
Extg Sq Ft F New/Added Sq Ft
r New rAdd r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F_—_
Use I I_�5I
Valuation$ 60r3
Total Sq Ft
# Stories I—7
F_ 3.Owner's Name Last
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FirstF—
Owner's Address
Owner's E-mail Address
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City N;porl co ar
State C/4
Zip �— Telephone—
r 4. Architect/Designer's Name
Last
First F— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State I
Zip F TelephoneF_
r 5. Engineer's Name Last
First Lic. No. F_
Engineers Address
Engineer's E-mail Address
City �
State F—
Zip [_ Telephonel—
r 6. Contractor's Name Last
1414ril ry
First 5,e 1-j Lic. i Nogbuo Class /(P
Contractor's Address
Contractor's E-mail Address
I ti oQ, 5. kt C)+Mlr.ru
corn
City I SA,v C'l-e"vjte_
State C/4
Zip q 4,71— Telephone cjr{ct L4g3--76oLq
OFFICE USE ONLY
PERMIT NO. EZ62J • 0gN9
TYPE OF CONSTRUCTION
PLAN CHECK NO. f—kZ�Z=�Z��
OCCUPANCY - GROUP
PLAN CHECK FEE $