HomeMy WebLinkAboutF2024-0130 - Permit Application (3)es URf �
City of Newport Beach Fire Permit Applicationfi� it
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Number and Street suite/unit zip
Associated Building Permit #
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Owner/Tenant
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Name
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Scope of work/
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misc. description
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Constr ction TI Addition Demolition
-Check one
Number of Stories per
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Commercial Fire Sprinkler
1 Number of FS Heads buil
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nMulti-Family(3+units) n Fire Alarm
E-71Number of FA Devices ❑ Number of Dwelling
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nResidential (1-2 units) I I Fire Underground
M Number of Risers
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*describe above
4 Applicant Information Name: ,^ Qt Lu rjeN 2
Address: 11A 1 H4, ,Qar St
Phone#: 714 ' � ortia I Email: Ck f,(�; �� rCirc� : u, �� �U
MCheck if same as Contractor
Designer Information Name: 0p, i 2
Address:
Phone#: Email:
®Check if same as Contractor
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Contractor Information Name: T)( ,\rQ-
Address: H 1 e ter -5(— 0 i CY '' A. Cr,
Phone#: 1i14 0DoJ149 ail: C,('_:C%t 42f
License#: C3 41 2v j Class: C,i (�
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Office Use Permit Plan Check tw4vto Permit/Plan
Number TO 1 Check Fee $
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