HomeMy WebLinkAboutF2021-0498 - Permit Application-dress
AGO DR
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
----=-`� z1 R FireSprinkler FireAlarm ��I�
mailing address) [Fire Misc
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r Name SANTIAGO REMODEL
----- -----
Description of Work
tE SPRINKLERS
HEADS
Ext9 S - - - -
q Ft ;
New/Added Sq Ft
Total Sq Ft
New � I
�Add [f' Alter
Demo
CheAppropriate Box for A
pplicant/Notification
3. Owner's Name
Last
Owner's Address -- - - -_.
--I
City - - -- --
State
(-4. Architect/Desi
gner's Name Last
Architect/Designer's Address - ------
City --- -
-__ _--
- --_-- State i
F75. Engineer's Name
First
Use
Floor-- - C.j S�uit�
7e No
___
# Units F7,
I
Valuation $ 2900
# Stories f2___7
--- First�
[ —�-
Architect/DesignerLic. No.
's E-mailE-- -
mil Address ----
ZipTelephone �
�-- _
-
Last -- -
Engineers Address ---- Engineer'sFirst'
--
- ---- __Lic. No
----- E-mail Address
City - --- _
State �-� — - --'
_I
L _ Zip _ - -
fX(6. Contractor's I --- Telephone'
Name Last CASEY I
Contractors Address - - --.- -- First MONTY -
1101 KINGSTON DR Contractors E-mail gddr ILic No.876004 Class C-16
F
Address
tY LA HABRA -- - FIREPROFMC@GMAIL _COM
State Cq
Zip90631 - -
-- - -- Telephone 714-476- - - - - -
FF/CE USE ONLY 5370
YPE OF CONSTRUCTION
CCUPANCY - GROUP
PERMIT NO. \
L
PLAN CHECK NO. `
7 PLAN CHECK FEE $