HomeMy WebLinkAboutF2020-0098 - Permit Application (2)Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach -Building Division F.Z0,70 - OOgg
FX- Fire Sprinkler [] Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
511 36TH ST
J
Tenant Name SIMPSON RESIDENCE
# Units
�I
State
Zip Telephone
2. Description of Work
First Ii Lic. No.
FIRE SPRINKLERS
Use
j
33 HEADS
State F777
Zip ! ' Telephone
❑ 5. Engineer's Name Last First F Lic. No.
Valuation $
3300
Extg Sq Ft � New/Added Sq Ft �, Total Sq Ft
City —
---
Zip L Telephoned
6. Contractor's Name Last CASEY First MONTY Lic. No. 876004
- I F W Class
G16
- -
Contractor's Address
# Stories
New r Add i7 Alter FI Demo
1101 KINGSTON DR
L3
Check Appropriate Box for Applicant/Notification
,i 3.Owner's Name Last
j First F
Owner's Address
Owner's E-mail Address
City
State
Zip Telephone
4. Architect/Designer's Name Last
First Ii Lic. No.
ArchitecNDesigner's Address
ArchitectlDesigner's E-mail Address
City
State F777
Zip ! ' Telephone
❑ 5. Engineer's Name Last First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City —
State �I
Zip L Telephoned
6. Contractor's Name Last CASEY First MONTY Lic. No. 876004
- I F W Class
G16
- -
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMCQGMAIL.COM
City LA HABRA J
State CA
Zip 90631 Telephone 714 476-5370
OFFICE USE ONLY
PERMIT NO. n 0 PSI I
`� ' ✓���
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $