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HomeMy WebLinkAboutF2023-0581 - Permit ApplicationWorksheet for Fire Permit Application ur,�M�Print Form City of Newport Beach -Building Division Please print 3 copies Associated Building Permit # I f�7 Fire Sprinkler F_ Fire Alarm r Fire Misc 1. Project Address (Not mailing address) / Floor Suite No Tenant Name "" -;}� ,\ %L r �� 1 r I�� #Units F- 2. /Description of Work Use Extg Sq Ft © 6 New/Added Sq Ft �— Total Sq Ft v L3 � Valuation $ �(,, 66' t r New F_ Add r Alter j— Demo # Storiesf Check Appropriate Box for Applicant/Notification F_ 3. Owner's Name Last First F Owner's Address Owner's E-mail Address City State F—• Zip F— TelephoneI� r 4. Architect/Designer's Name Last First F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State F— Zip F_ TelephoneF_ r 5. Engineer's Name Last First �— Lic. No. �— Engineers Address Engineer's E-mail Address State — �— Zip �— Telephone[ ,City" l .Contractor's Name Last First �� Il Lic No. lo) �j��? Class / Contractor's Address Contractor's E-mail Address � � � W f'C v� (h y ✓ �v 1P KA U1% i 1 rZ L ( tVo eld a 1 City a ^p State C/i ZiP O I, Telephone G 1 r�J 7v7J OFFICE USE ONLY PERMIT NO. ZoZ; -ci TYPE OF CONSTRUCTION 112Q 112,0 PLAN CHECK NO. • OCCUPANCY - GROUP �� ,7y PLAN CHECK FEE $ U