HomeMy WebLinkAboutF2023-0052 - Permit ApplicationPlease print 3 copies
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Associated Building Permit #
ire Sprinkler r, Fire Alarm F_l Fire Misc
1. Project Address (Not mailing address) Floor
Tenant Name I - - -+a, t- 5.'1_e._G_6- 6 -
2. Description of Work
# Units
Suite No
Use ------ -
Valuation $
E#g Sq Ft New/Added Sq Ft Total Sq Ft I -
F, New F Add r Alter F_ Demo �Lhtod�L
Check Appropriate Box for Applicant/Notification
# Stories
3.Owner's Name Last E,�L First
Owner's Address
Owner's E-mail Address
City ( �� PCj,:S-
Stated �� Zip �— Telephoned--
F7 4. Arch itect/Designer's Name Last
First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
city (
State Zip F— Telephonet_
r 5. Engineer's Name Last
First Lic. No. F_-
Engineers Address
Engineer's E-mail Address
City - _ -
State Zip Telephoned—
F_ 6. Contractor's Name Last 60 (j e- First p Lic. No. j) 17� Class FG-�
F,
Contractor's Address6G _z, j C
Contractor's E-mail Address
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City (ff" S goo
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State _L I F Zip L Zp )p Telephon
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OFFICE USE ONLY
PERMIT NO. Ov
TYPE OF CONSTRUCTION
11 PLAN CHECK NO.
OCCUPANCY - GROUP
l� PLAN CHECK FEE $
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