HomeMy WebLinkAboutF2024-0241 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application o?EW�R
City of Newport Beach - Building Division o
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/ ` Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
MIA -- --- poi -- V o (OF---- _ F_
Tenant Name # Units--
2. Description of Work
Extg Sq Ft F New/Added Sq Ft I l 8 Sa- Total Sq Ft F—
r New I— Add Ft/Alter j— Demo
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last First F_
Owner's Address Owner's E-mail Address
Use k42i
Valuation $
# Stories
City State I Zip F Telephoned
F_ 4. Arch itect/Designer's Name Last I First 7— Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
City - - State �— Zip �� Telephone
r 5. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City r State F Zip F Telephoned
6. Contractor's Name Last mC;lnn In First Lic. No. Class
Contractor's Address t Y 1 Contractors E-mail Address
City l l /^ State _(Azip _ Telephoned
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO.
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PLAN CHECK FEE $
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