HomeMy WebLinkAboutF2023-0408 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application N
City of Newport Beach - Building Division \', " • .fJ�/ j
r— Fire Sprinkler r Fire Alarm r— Fire Misc
1. Project Address (Not mailing address)
34o( Ser-��j
Tenant Name , . , _
2. Description of Work.( lI
Extg Scl Ft I New/Added Sg Ft
r New r Add [— Alter r Demo
Check Appropriate Box for Applicant/Notification
Total Sq Ft
Floor Suite No
I
# Units I
Use
Valuation $
# Stories F
F_ 3. Owner's Name Last �J/' ` / r Z� ��,
6\'
First F
Owner's Address
Owner's E-mail Address
3 1 o I A :, e=
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City
State �� �/ Zip
�T
�3 TelephoneF—
Ci 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_ Telephone
r 5. Engineer's Name Last
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip
F_ TelephoneF_
6. Contractor's Name Last d� /J�[�
�3
First ��vc , Lic No. �1� Class C
/
Contractor's Address
Contractor's E-mail Address
City
State �j� ,/A Zip
, Telephone L�� C',
OFFICE USE ONLY
PERMIT NO. b
�061
TYPE OF CONSTRUCTION
PLAN CHECK NO.61k'1�7•
OCCUPANCY- GROUP
PLAN CHECK FEE $