HomeMy WebLinkAboutF2023-0554 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler ❑ Fire Alarm
Fire Misc
1. Project Address (Not mailing address) Floor Suite No
7G 1 �iy ��Ce 17r;y—e C 9Z(o6 — FN%Vl
Tenant Name _I # Units A�
i 1C2i. f_�i • --
2. Description of Work
Use
'J Valuation $ (gyp
E#g Sq Ft ��� NewlAdded Sq Ft 2 (o%j(p Total Sq Ft ZI (O-r�0
New Add [Alter [I Demo #Stories F27-
t-.necK Appropriate tsox Tor Applicant/Notiticatlon
[J 3. Owner's Name Last �d S First
Owner's Address
City n6'% 1C..!- State -,i Zip
Owner's E-mail Address
- -- -- N1 -- --
Telephone
4. Architect/Designer's Name Last lI�G First Lic. No.
Architect/Designer's Address
q15 _lllt_iK \jew 0(ryr_ 286.
City yG,� ,vim' _ State
[. 5. Engineer's Name Last
Engineer's Address
City -i Str_L1 State
Architect/Designer's E-mail Address
ftk .
Zip �ZL11747 Telephone ft_ ?Z_�,>,
First 15 Lic No Ib-_%1ll`I'b
Engineer's E-mail Address
Zip z G 7 [ Telephone _ � 5y3 J (JU
. Contractor's Name Last C„� First Lic. No. f� E' class C �p j
Contractor's Address
19-7
city n) (� J State —
Contractor's E-mail Address
At
Zip ZQ7[ _ Telephone
OFFICE USE ONLY y � { V' PERMIT NO. r �'b-2— : ' > >'. -
TYPE OF CONSTRUCTION
��, S PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $
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