HomeMy WebLinkAboutF2018-0664 - Permit ApplicationWorksheet for Fire Permit Application
'Y`-Rt�rlt Form ! City of Newport Beach -Building Division
Please print 3 copies - 1� (�)r�LA
Associated Building Permit # r', Fire Sprinkler (-' Fire Alarm F_ Fire Misc
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1. Project Address (Not mailing address)
Floor
Suite No
3927SANDUNE
F
State F Zi �j Telephoned
P
Tenant Name FOSHEIM RESIDENCE
# Units
�I
Architect/Designer's Address
Architect/Designees E-mail Address
City- - -
2. Description of Work
F- 5. Engineer's Name Last
- First F777777 Lic. No.
J f
Engineer's Address
Use
- - --_ i-
City
FIRE SPRINKLERS 26 HEADS
r16. Contractor's Name Last CASEY First FON - Lic. No. 876004 Class C-16
- -
Contractor's Address
- -- -
Valuation $
2,600
Extg Sq Ft New/Added Sq Ft Total Sq Ft
State CA Zip 90631 Telephone 714-476-5370
_..
PERMIT NO.
# Stories
FNew rAdd �1 Alter (- Demo
OCCUPANCY - GROUP03
l
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Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name LasttV'OYW11
A First �^
Owner's Address
Owner's E-mail Addres
i
City
State F Zi �j Telephoned
P
4. Architect/Designer's Name Last
J First F77777 Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City- - -
State F! Zip Telephoned
F- 5. Engineer's Name Last
- First F777777 Lic. No.
J f
Engineer's Address
Engineer's E-mail Address
- - --_ i-
City
PI --�_I--- -
State Zi Telep hone
r16. Contractor's Name Last CASEY First FON - Lic. No. 876004 Class C-16
- -
Contractor's Address
Contractor's E-mail Address
1101KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
d PLAN CHECK NO.
OCCUPANCY - GROUP03
,�p�� PLAN CHECK FEE $