HomeMy WebLinkAboutF2024-0011 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies
City of Newport Beach - Building Division
4 G4`oPX�
Associated Building Permit# �j Fire Sprinkler nFire Alarm ❑FireMisc
1. Project Address (Not mailing address) Floor SuiteNo
,
Tenant Name p %Iti, �i'rY�/t — Units
2. Description of Work Ft dl J SL
rT��%-���-.. _Use _ -_-- _--_- --J
ExV SQ Ft f 75 --_I_i New/Added SQ Ft i I 1 I Total Scl Ft i Valuation $
New 'Add [ Alter [ Demo —F-f #Stories F
Check Appr6prifiate Box for ApplicantMotification
C 3. Ownees Name Last First
Owners Address Owner's E-mail
lAAddress
r
city State 7Jp 19 Telephone49 r
E 4. Architect/Designees Name Last
--� FirstlljIVbLV-)r Lic.
1Eiimllf •�9���/ �p� �r ra y „ tl\� / JV
[ S. Engineer's Name Last First
Engineers Address
C4 -- _ state �—
Engineers E-mail Address
Uc. No.
zip TelephoneF--�
[ S. Contractor's Name Last FirstFM Lic. No.
Contractors r Contractors E-mail Address
TcltyK��—i-- —_ State i/ /.4— ZrP Telephone
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO. F LOZ TI •
PLAN CHECK
PLAN CHECK FEE $