HomeMy WebLinkAboutF2023-0350 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application r
City of Newport Beach - Building Division
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Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
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Tenant Name I Lin/ 6t= (/�.,�-Z. �•��.�
Floor Suite No
# Units F
2. Description of Work
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Extg Sq Ft �— New/Added Sq Ft-- Total S9 Ft �— Valuation $�—
New r Add r Alter �7
(- Demo Zi/ #Stories 2,
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last f
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Owner's Address
Owner's E-mail Address
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CityK State F_C�Z� Zip q71 1 i Telephone
I— 4. Architect/Designer's Name Last
First �— Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip Telephone[
r 5. Engineer's Name Last n3 fllsc
First �,H
Engineer's Address Lic. No. f
Engineer's E-mail Address
City I j Y-y i r„C State �—
�A zip 9 ZP7l tf Telephone 32Z 0°t fir/
I— 6. Contractor's Name Last esir+� First—
t Lic No. Class
Contractor's Address C�p6Zy`� CJO
Contractor's E-mail Address
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City State F_ Zip
� Telephoned
OFFICE USE ONLY �(LZbZ3 - bZ% PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP W
PLAN CHECK FEE $ ( 7 6b