HomeMy WebLinkAboutF2020-0170 - Permit ApplicationWorksheet for Fire Permit Application
°°q@
fi „yifl6��or(
,? <v
%� City of Newport Beach -Building Division F.20Rt7 - O 176 a
Please print 3 copies k Uk a °<i,Mwf��
Associated Building Per --- -71 rg Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
4916 Seashore Dr, Newport Beach, Ca (upper residence) Sr�vC �E
_ - �oN
Owner's Address
Tenant Name Herrera Residence T, A% nits
2. Description of Work ON
State C71 Zip F_ ___7, TelephoneF 7
Fire Spinkler System , U
— �V -- -
Architect/Designees Address
E#g Sq Ft C New/Added Sq Ft [� Total Sq Ft 1,934
Valuation $
State E-7 Zip F_— TelephoneL
❑ 5. Engineer's Name Last
❑ New ❑ Add ❑ Iter Demo
#Storiesi
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City _.
State C71 Zip F_ ___7, TelephoneF 7
4. Architect/Designer's Name Last
-� First Lic. No. F77
Architect/Designees Address
i
Architect/Design is E-mail Address
City
State E-7 Zip F_— TelephoneL
❑ 5. Engineer's Name Last
_i First F_ — —7 Lic. No.
Engineer's Address
Engineer's E-mail Address
city
State F__71 Zip F__7 TelephoneF_7
n 6. Contractor's Name LastCamacho First Jose Lic. No. 890694 Class C-16
-- - - -
Contractor's Address
Contractor's E-mail Address
9225 Stellar Court, Suite A
Jose_Camacho@dceservicesinc.com
Cary Corona
State Ca Zip 92883 Telephone 951_667 4220 ext
OFFICE USE ONLY )r; i.-��/ PERMIT NO. _
TYPE OF CONSTRUCTION
CCUPANCY -GROUP
( PLAN CHECK NO.
zC ZO K( PIAN CHECK FEE $ _
s
FA