HomeMy WebLinkAboutF2023-0045 - Permit Application (2)Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # (— Fire Sprinkler r; Fire Alarm F_ Fire Misc
1. Project Address (Not mailing
Tenant Name
2. Description of Work
Floor Suite No
# Units
6' AO T_ � C Z JY b(� 1 �I FJZ� 3� Use
Extg Sg Ft New/Added So Ft 3"j 7 Z -I. Total Sci Ft 77 Z Valuation $ 60n7
# Stories 1
r New F_ Add F—AlterF_ Demo —
Check Appropriate Box for Applicant/Notification
F- 3. Owner's Name Last C%�Gf�1C�� First
Owner's Address Owner's E-mail Address
City Cc 1Fb is A OQ'L OANZ— state C (ov ' Zip �' Telephone
F_ 4. Architect/Designer's Name Last First F_ Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
City State F_ Zip F_ Telephoned
i— 5. Engineer's Name Last _ _ First Lic No. �.
9 I
Engineer's Address Engineer's E-mail Address
City � State F_ Zip F_ Telephoner
r 6. Contractor's Name Last �� First FS T ZU?;_ Lic. No. 4� Class FC - (�
Contractor's Address Contractor's E-mail Address
�1 ( S�vv�wtr 3�rF (M t tr t rcCOX_ a�
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City �L State Ca- Zip 9�L/c) Telephone ei5-e t7 n))_
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION '`� n�l /�� PLAN CHECK NO.
OCCUPANCY - GROUP y/ (�(J ` V PLAN CHECK FEE $