HomeMy WebLinkAboutF2023-0523 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler j— Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
00-7 J Q'I c, [L cy\e
Tenant Name
2. Description of Work
�V1SI� � I NQ,UJ �tr-� S�VIIf�ICI QY St�S+CYYI Ian �V'CS)�Q1�%�Ic`� ,/;(>MQ.
Extg Sq Ft F New/Added Sq Ft — Total Sq Ft
New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
I I
# Units F—
Use
Valuation $
# Stories P
r 3. Owner's Name Last
�—
First
Owner's Address
Owner's E-mail Address
City
State
�—
Zip F_ Telephoned---
F_ 4. Architect/Designer's Name
Last
First F Lic. No. I —
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
F—
Zip I— Telephoned--
r 5. Engineer's Name Last
First F Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City
State
I
Zip Telephone
6. Contractor's Name Lasty
vContractor's
j e
First j (y)Lic. No. �8_7361 Class r✓Ib
Address`
Contractor's E-mail Address
IZ-G( N, LCJ /
aJ..luh(i,—r..row-\
City yl I �,jti/1/1
State
CQ
Zip Z1��U Telephone iH-61' TIiS
OFFICE USE ONLY
PERMIT NO. L
TYPE OF CONSTRUCTION
PLAN CHECK NO
OCCUPANCY- GROUP
PLAN CHECK FEE $