HomeMy WebLinkAboutF2020-0478 - Permit ApplicationWorksheet for Fire Permit Application
Ptnt-Form. �- 1
City of Newport Beach - Building Division
Please print 3 copies k
Associated Building Permit #
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F Fire Sprinkler [-i Fire Alarm [i Fire Misc
1. Project Address (Not mailing address) Floor Suite No
119 SHORECLIFF DR —;
Tenant Name BENTLEY RESIDENCE # Units
2. Description of Work
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FIRE SPRINKLERSUse
61 HEADS
Zip [77777 Telephoned
Extg Sq FtF7777 New/Added Sq Ft Total Sq Ft
F
Valuation $ 6100
# Stories �2
�; New r Add r Alter j_-_ Demo
Architect/Designees E-mail Address
- 3 -SPCZ-
Check Appropriate Box for Applicant/Notification
f- 3. Owner's Name
Last First C �'
Owner's Address
Owner's E-mail Address
City
State F777
Zip [77777 Telephoned
F- 4. Architect/Designees Name Last First !! Lic. No. �—
Architect/Designees Address
Architect/Designees E-mail Address
City
State
Zip �� Telephone
❑5. Engineer's Name
Last
-
First Lic No
—
Engineer's Address
Engineer's E-mail Address
City State 77
Zip f Telephone!!
6. Contractor's Name Last CASEYrs
First MONTY Lic. No. F76004 Class C-16 I
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
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- - -
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA
Zip 90631 Telephone 714-476 5370
OFFICE USE ONLY
PERMIT NO. FZoZZ> - Dy
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
p `pt
L)q ZL f PLAN CHECK FEE $