HomeMy WebLinkAboutXR2024-5437 - Permit Application�Ewvpkr
City of Newport Beach Fire Permit Application
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Project Address
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Number and Street suite/unit
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Associated Building Permit #
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Owner / Tenant
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Name
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Scope of work/
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misc. description
Construction TI Addition Alteration
Demolition
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Number of Stories
Commercial Ej:Fire Sprinkl
[]Number of Heads
perbuilding
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Multi -Family (3+units) M Fire Alarm
Fkmber of Devices
Number of
Dwelling Units
Residential (1-2 units) MFire Underground
O Number of Risers
"Check one rl Fire Misc.
*Write in accurate count
*describe above
4 Applicant Information Name: rzc),Y�N kV�) t i
Address: 1-3 -rj. (, C-[ u�b� c;� C(9 a 2�
Phone#: qc q Cc kq -7-7 Q tp Email:
® Check if same as Contractor
Designer Information Name:
Address:
Phone#: Email:
0 Check if same as ontractor
Contractor Information Name:
Address:
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Phone#: Email:
License#: 22 Class:
Office Use
Permit Plan Check / Permit I Plan
Number � • (p7 Number �(,�(J2.,; 1Z$l Check Fee$
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