HomeMy WebLinkAboutF2023-0565 - Permit ApplicationWorksheet for Fire Permit Application OAP« "e
Print Form _
City of Newport Beach - Building Division
Please print 3 copies3
Associated Building Permit # XCU oIJ�j Fire Sprinkler [ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
106 Bob -new Clrcte. -- l
Tenant Name Green Sheet ndvisovs # Units 1
2. Description of Work L--�
the scope of war 1nUu6cs ihe. telom"or) and addition of o spnnKter heads I Use B-0{�
doe -to new wall av-\d light Iocahons.
i
Valuation $ Z,ZOO.pp
Extg Sq Ft New/Added Sq Ft Total Sq Ft 57B00sq. ft.
❑ New ❑ Add ® Alter ❑ Demo # Stories I (a
Check Appropriate Box for Applicant/Notification _
❑ 3. Owner's Name Last fdwordS First Jcannte
Owner's Address
Owner's E-mail Address
160 B0. •new ovue, s6k z l0
City Newport Beach ( State
Zip �1Z(n(u0 Telephone it318) 2(n5-1511
❑ 4. Architect/Designer's Name Last
First L Lic. No
I . �I
Architect/Designer's Address
ArchitecttDesigner's E-mail Address
City State
Zip Telephoned
❑ 5. Engineer's Name Last
_ j First C- Lic. No.
Engineer's Address
Engineer's E-mail Address
i
I
City I State
1
i
Zip r Telephoned
6. Contractor's Name Last J6t1(1Starl
First John _Lic. No. (cZRR93 'Class C-t�
Contractor's Address
Contractor's E-mail Address
199 12oyYYtar Rood. Stile N
_o)n@allprofirclnr.com
City Oteatvide State
577Zip
--_.--_i
q 058 Telephone (g511Zru9--391,
OFFICE USE ONLY
PERMIT NO. X C. 20 Z 3 — 04401
TYPE OF CONSTRUCTION
PLAN CHECK NO. 2a>r '0
OCCUPANCY - GROUP
PLAN CHECK FEE $