HomeMy WebLinkAboutF2023-0157 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
City of Newport Beach - Building Division °m
Please print 3 copies o
Associated Building Permit #
i— Fire Sprinkler r' Fire Alarm r- Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name I a
# Units �-
2. Description of Work
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Extg Sq Ft F—
New/Added Sq Ft F— Total S9 Ft
r New F_ Add (— Alter
I— Demo
Check Appropriate Box for Applicant/Notification
F_ Name Last
Owner's Address
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city
F 4. Arch itect/Designer's Name Last
First
Owner's E-mail Address
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State , — Zip F2irG0
Telephone
First
Use
Architect/Designer's Address
Architect/Designer's E-mail Address
Valuation$rl�i7�
# Stories
Lic. No.
City I State r--
ZiP F— Telephone—
r 5. Engineer's Name Last 6'P:t C
1� First � ,y
Lic. No. F
Engineer's Address
Engineer's E-mail Address
city �'I/ State
Cs. Zip 9a�i� Telephone 9y9-92s-Goon
r 6. Contractor's Name Last `...�.y GnFirs, ��oLiNo707�
Contractor's Address r Class
✓
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Contractor's E-mail Address
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City ,� �� h State �—
Zip %'6N) Telephone
OFFICE USE ONLY PERMIT NO, F?2Z'3i-0(s%
TYPE OF CONSTRUCTION PLAN CHECK NO. r C �L3 — 7
OCCUPANCY - GROUP 5
PLAN CHECK FEE $