HomeMy WebLinkAboutF2022-0029 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application UW
City of Newport Beach - Building Division oo�-�
Fx Fire Sprinkler F- Fire Alarm j— Fire Misc
1. Project Address (Not mailing address)
12132 E.00EAND BLVD
Tenant Name CALLAGHAN RESIDENCE
2. Description of Work
FIRE SPRINKLERS
32 HEADS
Extg Sq Ft New/Added Sq Ft
-X New j Add Alter F Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
— -- F_
# Units
Use
Valuation $ I3200
Total Sq Ft �—
# Stories �3
3. Owner's Name Last I
-
First
Owner's Address
Owner's E-mail Address
I
City State
Zip F Telephonel�
f 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F^� State
Zip I Telephone!
F_ 5. Engineer's Name Last li
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State e
Zip I Telephone f -
r 6. Contractor's Name Last I,CASEY
First iMONTY Lic No. 876004 Class Z16
Contractor's Address
Contractor's E-mail Address
�1101 KINGSTON DR
IFIREPROOFMC@GMAIL.COM
City FLA HABARA State
ICA Zip I90631 Telephone 1714-476-5370
OFFICE USE ONLY
_�LO' b1`97 PERMIT NO. r7-07-2-
TYPE OF CONSTRUCTION
*17ebk PLAN CHECK NO.
OCCUPANCY- GROUP
n ^� F 0" PLAN CHECK FEE $