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F2020-0032 - Permit Application
Worksheet for Fire Permit Application City of Newport Beach - Building Division Please print 3 copies r M-� ID - O U 3 Associated Building Permit # JI ` e � �; r Fire Splrriinkler [ Fire Alarm rl Fire Misc 1. Project Address (Not mailing address) Floor Suite No I 3904 CHANNEL PL! --- - - - -- -- -- -- - Tenant Name M- ID -CON CHANNEL PL # Units ---- -- ----- -- - - -------J 2. Description of Work Use n 4. Architect/Designer's Name LastI First Lic. No. FIRE SPRINKLERS Architect/Designer's Address Architect/Designefs E-mail Address 46 HEADS Valuation $ 4600 F ��� �; E Sq Ft I New/Added Sq Ft l Total Sq Ft I _ - Engineer's Address Engineer's E-mail Address. # Stories LLL © New [ Add [j Alter [ Demo Check Appropriate Box for Applicant/Notification Infnrma+inn [ 3. Owner's Name Last — First Owner's Address Owner's E-mail Address City - - - State �I Zip Telephone; n 4. Architect/Designer's Name LastI First Lic. No. Architect/Designer's Address Architect/Designefs E-mail Address City State Zip - Telephone } I 5. Engineer's Name LastJj First u Lic. No. Engineer's Address Engineer's E-mail Address. City State F_71 Zip Telephone ., [j 6. Contractor's Name Last CASEY First RONTY _ J'I Lic. No. 876004 i ClassC-1671 Contractor's Address Contractor's E-mail Address 1101 KINGSTON DR FIREPROOFMC@GMAIL.-CCO OM ------ -- -- - ----------- ity LA HABRA State CA Zip 90631�I Telephone 714476-5370 - I -I F - -- -- `CE USE ONLY PERMIT NO. OF CONSTRUCTION PLAN CHECK NO. O • oANCY - GROUP Hyl •, t� a PLAN CHECK FEE $