HomeMy WebLinkAboutF2019-0575 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler Fire Alarm
1. Project Address (Not mailing address) Floor Suite No
127 JADE AVE -- �,
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Tenant Name BAKSHI RESIDENCE #Units
Owners E-mail Address
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2. Description of Work
Use
F'4. Architect/Designer's Name Last - First F777777 Lic. No.
FIRE SPRINKLE RS
Architect/Designers E-mail Address
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City State Zip Telephoned
28 HEADS
Last First
-- --.- - Lic. No.
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Valuation $ 2,800
Engineers E-mail Address
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Extg Sq Ft �! New/Added Sq Ft Total Sq Ft I �
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6. Contractor's Name
# Stories 37
IX; New Iii Add Alter [I Demo
Contractors E-mail Address
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last First II'
Owner's Address
Owners E-mail Address
I
_------- - - --
City
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State F77 Zip F7777 TelephoneF
F'4. Architect/Designer's Name Last - First F777777 Lic. No.
Architect/Designees Address
Architect/Designers E-mail Address
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City State Zip Telephoned
5. En meer's Name
9
Last First
-- --.- - Lic. No.
J -- --
Engineers Address
Engineers E-mail Address
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City
State F—'I Zip F__� Telephone
6. Contractor's Name
Last CASEY - -j First MONTY- - Lic. No. 876004 Class C-16-
Contractors Address
Contractors E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
J StateCA Zip 90631 Telephone 714-476 5370 J
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OFFICE USE ONLY
PERMIT NO. '�-�t�• fl�
TYPE OF CONSTRUCTION ` PLAN CHECK NO.
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OCCUPANCY- GROUP
PLAN CHECK FEE $