HomeMy WebLinkAboutF2023-0202 - Permit ApplicationPrint Form Worksheet for Fire Permit Application W�Rr
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City of Newport Beach -Building Division
Please print 3 copies
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arm I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
11 Cor Qoraic plaza t°' I I2�O
Tenant Name . NeWpo(4 Ccoicr SUrgiCGl I #Units I —
2. Description of Work
inc �Vvc ur wotF InclUgfj i-Y)e retocanon of CI) exjshv)(, Pi s)mnKler Use B•01fice
head &t +o hew wall and tight locations. -
Extg Sq Ft F—Valuation$ I.200-00 New/Added Sq Ft �— Total Sq Ft (Q, 3(v9 - -- ---
r New r Add IX Alter Stories Alter (— Demo �-
a+.aa+...�.-y+pn vMna�a oWA rvi mpplluanurvoilin cation
(— 3.Owner's Name Last
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First F w)11igrp
Owner's Address
Owner's E-mail Address
1-7 COrPOralrt- Plaza, suik zao
City I NCWp0f-i 13eaG11
State Cp Zip
q (p(p0 Telephone C%9)CAG- IM1
I— 4. Architect/Designer's Name
Last
First F— Lic. No. F—
ArchitecUDesigner's Address
Architect(Designers E-mail Address
City I_
State F-- Zip F— Telephone—
r 5. Engineer's Name Last
First F_ Lic. No. �—
Engineers Address
Engineer's E-mail Address
City
State F— zip
F— TelephoneF_
IX 6. Contractor's Name Last �OhY1StOr
First —O Lic. No. (o2g993 Class FC I(a
Contractors Address
Contractors E-mail Address
liq Rotuma( iZoad Suiie ii
10,nnC&allpro{=iteinc.corn
city Oceans)de.
state I Cp zip
92056 Telephone (q51) 2G4- 3912_
OFFICE USE ONLY
G7 T7 �1 Z (.83 PERMIT NO. ftt;7,1;
TYPE OF CONSTRUCTION
C� l_Jn�
I C1 ZCI PLAN CHECK NO. Qe-1 J 3 —
OCCUPANCY - GROUP
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PLAN CHECK FEE $
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