HomeMy WebLinkAboutF2019-0517 - Permit Applicationi; Print Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
v j F_ Fire Sprinkler n Fire Alarm F Fire Misc
1. Project Address (Not mailing address) ~� Floor Suite No
•I-3 ) (BLDG 2)
- - -
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Tenant Name Units
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2. Description of Work
[i 4. Architect/Designer's
Name Last First Lic. No.
INSTALLATION OF FIRE SPRINKLER MONITORING
Use RESEENTIAL
-S� -� -dam
Valuation $ $2,800.00
14
Extg Sq Ft �i New/Added Sq Ft Total Sq Ft ,965
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# Stories
F7
n New (- Add F Alter r
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
Inns r. nfl^n
3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
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City
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State Zip F Telephoned
[i 4. Architect/Designer's
Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City
State I Zip I Telephone—i
n 5. Engineer's Name
Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
ity
State Zip F TelephoneF
F>-4- Name
Last RODGERS First CHRIS I Lic. No. 854971 ClassC-10
Contractor's Address
Contractor's E-mail Address
705 E. HARRISON STREET #200 CHRISR@FIREINC.NET
City CORONA
State CA Zip 92879 Telephone 951-452-5936 l
OFFICE USE ONLY
PERMIT NO. .rZOIl ff�A
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $