HomeMy WebLinkAboutF2024-0130 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # i Xi Fire Sprinkler F1 Fire Alarm [] Fire Misc
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1. Project Address (Not mailin
Ll0o BabNAew Gro e, --- — ------ ----- z
Tenant Name (�Ot TpWer CoK �100f COffirrlbn 1iYQa UP
2. Description of Work
u scope of worts includes the tciocation of cts) ¢x�sting-five-SprinKlrr_ _-
eods dvc % new Umq and light locations.
Extg Sq Ft New/Added Sq Ft Total SQ Ft 223
' 2, _I
(� New [ Add [; Alter j- Demo
unecK Appropriate t3ox for Applicant/Notification
Floor Suite No
#units
ei
Valuation $ 3 200.00 1,
# Stories L
3. Owner's Name
Last I Edwards First.
Owner's Address
Owner's E-mail Address
10o BayV\!W aycw , SkAlt Z50
City NitwPor+ beach
State CP Zip Alw o Telephone (q9q� IZS gy001
F4. Architect/Designer's Name Last _ — First F—. Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State—, Zip F—,. Telephone-
r 5. Engineer's Name
Last First-
-- — --- - Lic. No.
LLL
Engineers Address
Engineer's E-mail Address
City
State F`' Zip Telephonee
CK6. Contractor's Name Last
1�rnS" First Jahn Lic. No. (029493 Class C I(n
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Contractor's Address
Contractors E-mail Address
ncl RNxmv- Road. -C"Ve IR _ — �4>1n@allproH�ethccart
city ou-c'n5we
State �— Zip gZOSt3 Telephone N51)2tO4- t17,
OFFICE USE ONLY
PERMIT NO. OZ
O I O
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $