HomeMy WebLinkAboutF2023-0440 - Permit Application® Worksheet for Fire Permit Application
City of Newport Beach -Building Division
Please print 3 copies
Associated Building Permit # XR2022-2667
F. Project Address (Not mailing address)
lr6;03 &603 1/2 Acacia
Tenant Name
2. Description of Work
ire SpfifiRlEf esign ea s
Unit 1 -1646 Sq Ft
Unit 2 -1314 So Ft
Extg Sq Ft F — New/Added Sq Ft
jx New F- Add r Alter r Demo
u
r Fire Sprinkler j- Fire Alarm F- Fire Misc
Check Appropriate Box for ApplicantlNotification
Total Sq Ft 2960
U
Floor Suite No
# Units F
Use
Valuation $
# Stories I3
r 3.Owner's Name Last
First I
Owner's E-mail Address
Owner's Address
State [—--
zip F— Telephoned
City
r First Lic. No.
4. Architect/Designer's Name Last
�—
ArchitecUDesigner's E-mail Address
Architect/Designees Address
I
State �_ zip � Telephone
City �
f- 5. Engineer's Name Last
First �— Lic. No.
Engineer's E-mail Address -
Engineer's Address
State F_ Zip F� Telephone
City
� 6. Contractor's Name Last Lopez
First Gus Lic. No.IB90694 uassl�-
Contractor's E-mail Address
Contractor's Address
NPF!re@riceservicesinc.com
9129 Stellar Ct.
City Corona
State CA Zip 92863 Telephone 951-667-4220 e
PERMIT NO. ' `
'110E USE ONLY Q
PLAN CHECK NO. `.
-IF CONSTRUCTION
PLAN CHECK FEE $
,CY - GROUP