HomeMy WebLinkAboutF2022-0626 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # x Fire Sprinkler j- Fire Alarm j-; Fire Misc
1. Project Address (Not mailing address)
Tenant Name 2-
-�-igNS�—REs.+�f c�._
2. Description of Work
L C14� eS!den�a2 S� i�kle % r�s Ta P&J aco,T
Extg Sq Ft ID6JS. !. New/Added Sq Ft - ci5_ Total Sq Ft
[-, New dd j-; Alter i- Demo
%+neGK Appropriate tsox Tor App icant/NOLltication
Floor Suite No
F
# Units (
Use
Valuation$ !_--((ULL--
# Stories F
3.Owner's Name Last -'-A.)J � First N(ifia--
Owner's Address
-
Owners E-mail Address
3 OG RIb_ Cs
pit_ . - - C� i�l'S1r�BaDvr .am
City NEwRI(T- (-'OAS-I State
Zip 9,P&T Telephone qi_Qpi-7
F_ 4. Architect/Designer's Name Last
_
First I j ' Lic. No. F—
- av�o
Architect/Designers Address
-
Architect/Designer's E-mail Address
e0Q0( A
DA 1D41 l?H!� 451(�J , CDrr� -
City State
Zip,_ Telephoner3 �_33y
F 5. Engineer's Name Last
- ------
- __ Lic. No. �--
FirstLic._.N.
Engineer's Address
I
Engineer's E-mail Address
City State
�- Zip F_! Telephone—
J
r 6. Contractor's Name Last P First Cif Lic No. Qqq s� j Class G((o
Contractors Address
Contractor's E-mail Address
`? (602 MTbM�
cd C� Cho, an-
City State
�- Zip Q��1j� Telephone-yl�-�(,-O--QIUj
OFFICE USE ONLY
PERMIT NO, DHOW
TYPE OF CONSTRUCTION
PLAN CHECK NO. T(4421Z O20
OCCUPANCY -GROUP
PLAN CHECK FEE $