HomeMy WebLinkAboutF2018-0542 - Permit ApplicationF 7-0\170 -O �D j -I Z 'DZoI �b•o�tto-►
Worksheet for Fire Permit Application SWONCity of Newport Beach - Building Division
Please print 3 copies C) 4•q *,l Q
Associated Building Permit# ��Lol�i.- ayf�1 fX- Fire Sprinkler F7 Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2017 E BAL•Befl BLVD
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Tenant Name CEFALIA RESIDENCE nits F77
2. Description of Work
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Use �—
FIRE SPRINKLERS 34 HEADS
Zip _ iZia,, Telephone
j- 4. Architect/Designees
Valuation $ 3400.00
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
Architect/Designees E-mail Address
# Stories
rx- New F' Add r Alter r Demo
I-
Check Appropriate Box for Applicant/Notification
InF�•m�4i�n
r
3. Owner's Name
LastCR�lPf
First J ►N
Owner's Address
Owner's E-mail Address
City State
Zip _ iZia,, Telephone
j- 4. Architect/Designees
Name Last First Lic. No.
Architect/Designers Address
Architect/Designees E-mail Address
City
State r
Zip [77- 7 Telephoned
F_ 5. Engineer's Name
Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City -
- State 37
i
Zip F--77 Telephone
6. Contractor's Name
Last CASEY First IMONTY - Lic. No. 876004 Class T
Contractor's Address
Contractors E-mail Address
1101 KINGSTON DR
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- - --
FIREPROOFMC@GMAIL.COM
City LA HABRA
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State CA
Zip 90631 Telephone 714 476-5370
OFFICE USE ONLY
PERMIT NO. �� t q% • d'
TYPE OF CONSTRUCTION
PLAN CHECK NO.+ • �I
OCCUPANCY- GROUP
PLAN CHECK FEE $