HomeMy WebLinkAboutF2016-0306 - Permit ApplicationWorksheet for Fire Permit Application
PnnfrForm' != City of Newport Beach - Building Division 3
Please print 3 copies P:z o w _
Associated Building Permit# ]— Fire Sprinkler [_ Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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212 Via Mentone I- F
_. _._ _.. _ _
Tenant Name. _. _..
# Units r—,..
Owner's Address
2. Description of Work
Owner's E-mail Address
City F_
Use '
Design and installation of all over head piping and sprinkler heads for fire sprinkler system.
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10 f7�(, ._
$ 6724
Extg Sq Ft F— New/Added Sq Ft Total Sq Ft
.Valuation
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Architect/Designer's E-mail Address
# Stories
CX New � Alter r Demo
F_ Add
Zip F Telephone!.`
Check Appropriate Box for Applicant/Notification
[` 3. Owner's Name Last---
First,
Owner's Address
Owner's E-mail Address
City F_
State F_—_
Zip F_ Telephone
F_ 4. Architect/Designer's Name Last
First F Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City _
State
Zip F Telephone!.`
(- 5. Engineer's Name Last (Limon
FirstJuan Lic. No.F
Engineer's Address
Engineer's E-mail Address
8085 E. Crystal Dr.
juanl@resfire.com
City Anaheim
State CA
Zip 92807 Telephone (714)666-8450
F_ 6. Contractor's Name Last Residential Fire Systems
First F— Lic. No. 786965 Class C-16
Contractor's Address
Contractor's E-mail Address
8085 E. Crystal Dr.
juanl@resfire.com
Cit Anaheim
State CA
Zip 92807 Telephone (714)666-8450
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. ✓y
020/
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OCCUPANCY - GROUP
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��� PLAN CHECK FEE $
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