HomeMy WebLinkAboutF2024-0032 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I A m y)- Q/mAv
(- Fire Sprinkler rFire Alarm r Fire Misc
1. Project Address (Not mailing address)
20 `-o \ w1-vtM F* ?" �rcv _ st -
Tenant Name �t,CaYA-AVI C�sAg}^UC1l,, C.-9-
2. Description of Work
-�v "mYw- ads tyn l Ass N-p6
Extg Sq Ft F— New/Added Sq Ft Total Sq Ft L2)/ SbO
I— New r Add T Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units r
Use p/ Q-A
Valuation $ j2 �4$Iao
#Stories r3
3. Owner's Name Last
�CY C(a15CYUC_�a^ First —
Owner's Address
Owners E-mail Address
City
State Zip Zt,pIEQ TelephoneF_�-
i- 4. Architect/Designer's Name
Last First I Lic. No. r—
Arch itect/Designer's Address
Architect/Designer's E-mail Address
City I�
State F— Zip [— Telephoned`
[_ 5. Engineer's Name Last
First F— Lic No. F_
Engineer's Address
Engineer's E-mail Address
City
State F— Zip F— Telephonet
t fi. Contractor's Name Last �/te 1 �(j�/ First '0�' 1� Lic No. -1- p� Class 7i o
V"vl
Contractor's Address
Contractor's E-mail Address
Ut _6u NO \0,(- @
Ciln#
i J �
tONNLY
State r� Zip l `! Telephone q o f 7 OS - ( Q OO
OFFICE USE
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO '
OCCUPANCY - GROUP
PLAN CHECK FEE $