HomeMy WebLinkAboutF2019-0512 - Permit Application�FU L_q --Dt5ll, Worksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies -,:3epw �<; o,w•
Associated Building Permit # _ V_ i r', Fire Sprinkler jXl Fire Alarm rl Fire Misc
1. Project Address (Not mailing address) Floor Suite No
3351,3353,3355,3357 Via Lido (4 P EX) (BLDG 1)
#Units 4
Tenant Name 4 �,
i
Owner's E-mail Address y ,
City
2. Description of Work
Zip F—' Telephone's
INSTALLATION OF FIRE SPRINKLER MONITORING
Use RESIDENTIAL
First F Lic. No.
Architeect/Designer's Address
Extg Sq Ft F-1 New/Added Sq Ft Total Sq Ft 11,972
Valuation $ $2,800.00
# Stories3
IX' New n Add r Alter F-1Demo-
f---
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
First F�I
Owner's Address
Owner's E-mail Address y ,
City
State F—
Zip F—' Telephone's
ri 4. Architect/Designer's Name
Last �—
First F Lic. No.
Architeect/Designer's Address
Architect/Designer's E-mail Address
City _
_.. State
Zip Telephone F_
rl 5. Engineer's Name Last f
First Lic. No.
Engineer's Address
Engineer's E-mail Address
ity
State F_I
Zip - Telephone
1^II'i ..Contractor's Name Last RODGERS'�. First CHRIS ��, Lic. No. 854971. Class C-10
Cc dctor's Address�
_
d' Contractor's E-mail Address
705 E. HARRISON STREET #200
JCHRISR@FIREINC.NET
City CORONA
State CA
Zip 92879 Telephone 951 452- 3E
OFFICE USE ONLY
PERMITNO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
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