HomeMy WebLinkAboutF2025-5294 - Permit ApplicationCity of Newport Beach Fire Permit Application'°
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1 Project Address b 00 �i57o 0 S� i jC) Z6 LU
Number and Street suite/unit zip
12
Associated Building Permit #
Owner / Tenant
Name
3 1 Scope of work/
misc. descriatiot
TI Addition Alteration Demolition
*Check one
Commercial
Fire Sprinkler
13 LJ13RH13D
Multi -Family (3+units)
0 Fire Alarm
OResidential(1-2 units)
Fire Underground
*Check one
Fire Misc.
*describe above
1
Number of Stories
Number of Heads
per building
lumber of Devices
MNumber of
Dwelling Units
^
1
1 Number of Risers
*Write in accurate count
4 Applicant Information Name: ( " \,o ff.}; j o
Address:
Phone#: Email:
ED Check if same as Contractor
Designer Information Name:
Address:
Phone#: Email:
Q Check if same as Contractor Contractor Information Name: Pkt , ,- w) 1" n7 � r,4- n
Phone#: ?,Lq - ell4cl Email: sot
License#: ,-A /q,,— Class:
Office Use/
Permit � /'� I q Plan Check Permit / Plan
Number �f �1J P"('r1 I Number Check Fee$