HomeMy WebLinkAboutF2024-0519 - Permit ApplicationCity of Newport Beach Fire Permit Application
Coto,...,1
1
Project Address
n jj 2,
`� � � � nct e � F `� �'�� ��a 1�� �
[, F-'VF c' h /
Number and Street suite/unit zip
Associated Building Permit # J �g
Owner / Tenant
2
Name
Scope of work/
/Vt L_� r $'pd-in Eft - �j�j tom.. "17PA l3 77/
3
mist. description
i v r 7% -3 .4�_i�e 4pri�k)e� �icc,i/
Con tr pion TI Addition Alteration Demolition
*Check one
Number of Stories
Commercial Fire Sprinkler
91:3
Number of Heads per building
LJ13R 413D
Multi-Family(3+units) 0 Fire Alarm
Fkmber of Devices ❑ Number of
Dwelling Units
OResidential (1-2 units) Fire Underground
M Number of Risers
*Check one M Fire Misc.
*Write in accurate count
*describe above
4 Applicant Information Name: 0. kQ ant
Address: r 2 7 Ck?rc�-A k� c)vYq kaJ13 MLOI
Phone#: V5 Z '2z79 79116Email: ;r� ;rt ''. M' ,i
IS] Check if same as Contractor
Designer Information Name:
Address:
Phone#: Email:
Check if same as Contractor
Contractor Information Name:
Address: cx.� ov0
Phone#: Email:
License#: 2-0 l 111) 11 Class: C / (�
Office Use
Permit Plan Check Permit I Plan
Number Number Check Fee $
VC - L5