HomeMy WebLinkAboutF2023-0475 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (N mai
(0 2 �'i n
Worksheet for Fire Permit Application UQ,
City of Newport Beach - Building Division
Fire Sprinkler (— Fire Alarm j— Fire Misc
address)
Tenant Name MUM
2. Description of Work
NQvN
Extg Sq Ft r— New/Added Sq Ft r — Total Sq Ft
F_ New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last Co First
Owners Address
Floor Suite No
It Units �—
Use �l
Valuation $ FIWL4Q __
# Stories r
Owner's E-mail Address
io2 TIB^ I�LI
City State F_ Zip Telephoned
i— 4. Architect/Designer's Name Last
FirstArch F — Lic. No.
---- ect/De-----'s Address Architect/Designer's E-mail Address
City I State
F_ Zip [� Telephoned
I— 5. Engineer's Name Last CairNI Q� 1 1 First ec
1 0V` Lic No. F_
Engineer's Address
(r� Engineer's E-mail Address
OA
City F State r—
Zip F� Telephone[�
(— 6. Contractor's Name Last I h 0, Q, First FP(
I 1
�� Lic. No. "I�' Class t- t Uj
Contractor's Address
Contractor's E- At Address
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City State (R Zip I t I Telephone gLlof q ✓0 �I� 1 1
OFFICE USE ONLY O-+ PERMIT NO. ZOY'� , p E) 17�
TYPE OF CONSTRUCTION yjpt2.•I
PLAN CHECK NO. L
OCCUPANCY -GROUP -�1. zj��9
PLAN CHECK FEE $