HomeMy WebLinkAboutF2024-0597 - Permit Application12
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City of Newport Beach Fire Permit Application
Project Address a ^, Le 0r+ p e� f n 7
Number and Street suite/unit zip
Associated Building Permit # x C ZOZq Q LL�
Owner/Tenant J/
Name / (� U r n l ��aaz -e
Scope of work/ t=�f/Pnfl Z
misc. description
New
Construction TI Addition Alteration Demolition
*Check one
U
Commercial
13 13R 13D
Fire Sprinkler
Number of Stories
1 Number of Heads per building
r—IlNumber of Devices Number of
Dwelling Units
MNumber of Risers
*Write in accurate count
4 Applicant Information Name:
Address:
Phone#: Email:
Check if same as Contractor
Designer Information Name:
Address:
Phone#: Email:
0 Check if same as Contractor
Contractor Information Name: Dan'1 iorQJi� ��L F fP �lDfa �,'r6vi
Phone#: fly ;0a /yl� Email•dc fe(tfFcho � r / �dm
License#: 4 �p� Class: CIh
Office Use
Permit !1 Plan Check '/�
Number ,OV Number �� Permit/Plan
I S eck Fee $
*Write in accurate count
4 Applicant Information Name:
Address:
Phone#: Email:
Check if same as Contractor
Designer Information Name:
Address:
Phone#: Email:
0 Check if same as Contractor
Contractor Information Name: Dan'1 iorQJi� ��L F fP �lDfa �,'r6vi
Phone#: fly ;0a /yl� Email•dc fe(tfFcho � r / �dm
License#: 4 �p� Class: CIh
Office Use
Permit !1 Plan Check '/�
Number ,OV Number �� Permit/Plan
I S eck Fee $