HomeMy WebLinkAboutF2022-0407 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print} copies
Associated Building Permit # F�' Fire Sprinkler Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing
Tenant Name
2. Description of Work
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Floorr Suite o
' �o—' —'
# Units
2> Use O
Valuation $� Q
Extg Sq Ft New/Added Sq Ft �� Total Sq Ft
I 14,
ElNew ❑Add ❑Alter ❑# StoriesDemo
Check Appropriate Box for Applicant/Notification
[713. Owner's Name .
Lash 1N� �� p i lyrst�
Owner's Address
Owner's E-mail Address
City
State E�V] Zip ' - 1'7 i Telephoned 4/
❑ 4. Architect/Designer's Name Last First I I Lic. No. �
Architect/Designees Address
Architect/Designer's E-mail Address
City State Zip Telephone
❑ 5. Engineer's Name
Last i Jh'J—l1aJZ, First t:C Lic No.
Engineer's Address
Engineer's E-mail Address
City ��{' }��p
State I /.6- Zip Telephone d - 30 (,bao
�I—t I�
❑6. Contractor's Name Last
/ Opt Lic. No. F= ClassF
I _
Contractor's Address
Contractor's E-mail Address
City
i
.I State �� Zip �i Telephoned
OFFICE USE ONLY
PERMIT NO. FZdI/Z — D 90
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $