HomeMy WebLinkAboutF2024-0091 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkle F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
// L / i % to F_ F—
Tenant Name ���- �� /�� /�� # Units rZ
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2. Description of Work
Fl�p� �
Use �—
Extg Sq Ft F_ New/Added Sq Ft �— Total Sq Ft �—
Valuation $
r New i— Add r Alter r Demo
# Stories
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First r—
Owner's Address
Owner's E-mail Address
l& // Lin= p r,
City ����,/J, �� ���{�_/7` State
�� Zip ���� Telephoned
F_ 4. Architect/Designer's Name Last
First F— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State
F_ Zip F Telephone
r 5. Engineer's Name Last
First F_ Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City State
F_ Zip F_ Telephoned
I— 6. Contractor's Name Last CO e Z First Lic No. 7/,/7-,6 Class v ��
P_ C
Contractor's Address
Contractor's E-mail Address
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��?ZK� C�- P Lune Garr
City �2/S 1v'K/ State
J�
/�� Zip G/',2C�1 Telephone
OFFICE USE USE ONLY
PERMIT NO. 2CZ4
TYPE OF CONSTRUCTION
PLAN CHECK NO. ��y
OCCUPANCY - GROUP
PLAN CHECK FEE $