HomeMy WebLinkAboutF2023-0213 - Permit ApplicationPrint ForWorksheet for Fire Permit Application o;e
m City of Newport Beach - Building Division
Please print 3 copies_
Associated Building Permit #
XFire Sprinkler r Fire Alarm r— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
4o1v Fff
' l cU-
l
Tenant Name # Units �-
2. Description of Work
Use Q��y
r
Extg Sq Ft I New/Added Sq Ft F— Total Sq Ft �—
Valuation $ ('f dv
(- New (— Add � Demo Alter
(—
#Stories I
Check Appropriate Box for Applicant/Notif!cation
3. Owner's Name Last FirstF—
Owner's Address Owner's E-mail Address
119
I� 0 oaf City State I v�_ ZipF 1 /l���LLL
elephoneF—
F 4. Architect/Designer's Name Last 111111 First /� Lic. No. �—
Architect/Designer's Address Architect/Designers E-mail Address
City State F_ Zip F— Telephone—
r 5. Engineer's Name Last First F_ Lic. No. �—
Engineer's Address Engineer's E-mail Address
City State I— Zip F_ Telephoned
r 6. Contractor's Name Last �I j g�j apt' First ftl T/17M4c No. IA (, Class F—
Contractor's Address I C (r (' Contractor's E-mail Address
City State "� Zip
I Telephone- T l kH
OFFICE USE ONLY PERMIT NO. FZ6Z
TYPE OF CONSTRUCTION PLAN CHECK NO. PC Z 02 �O�J
OCCUPANCY - GROUP PLAN CHECK FEE $