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HomeMy WebLinkAboutF2023-0336 - Permit ApplicationWorksheet for Fire Permit Application Print Form City of Newport Beach - Building Division Please print 3 copies Associated Building Permit # Q Fire Sprinkler r Fire Alarm r Fire Misc 1. Project Address (Not mailing address) 11 � k...S, PI�t Tenant Name 2. Description of Work Nkk.k �_ �ctki �Q 2X�r<;,i sy,c cw. Extg Sq Ft F_ New/Added Sq Ft r— New IR Add r Alter r Demo Check Appropriate Box for Applicant/Notification KI.t.J„ Total Sq Ft �— Floor Suite No I # Units F Use Valuation $ # Stories r 3.Owner's Name Last '��\� \ FirstF Owners Address Owner's E-mail Address City I State F_ Zip F-- Telephoned r 4. Architect/Designer's Name Last First 7— Lic, No. F Architect/Designers Address Architect/Designer's E-mail Address City I State F__ Zip F Telephoned r 5. Engineer's Name Last �— First F_ Lic. No. F_ Engineer's Address Engineers E-mail Address City State F Zip F_ Telephoned r• 6. Contractor's Name Last 1t� First fZ Lic No. bwl)04 Class C-1 Contractor's Address Address++ Contractor's E-mail Address 11 �� t^t1SiT •� P,'O L {aIt- IVr••T h•c©�ry.t(1, c•y.` City I Lc State CN Zip 5 o F)1 Telephone OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO. Q� OCCUPANCY - GROUP PLAN CHECK FEE $