HomeMy WebLinkAboutF2022-0635 - Permit ApplicationPrint FormWorksheet for Fire Permit Application
Please print 3 copies `���ow�" o EWPO
City of Newport Beach - Building Division � . '�
Associated Building Permit #
r Fire Sprinkler i— Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2018 NAUTILUS LANE
Tenant Name CUSTOM REMODEL CABANA ONLY # Units
I
2. Description of Work
_
Use
FIRE SPRINKLERS
2 HEADS
Extg Sq Ft F— New/Added Sq Ft F— Total Sq Ft F_
Valuation $ 200
I
# Stories 1
IjX
New F_Add F_Alter F_Demo
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name
Last
First F_
Owner's Address
Owner's E-mail Address
City
State F_—
Zip Telephone
F 4. Arch itecUDesigner's
Name Last
i
First Lic. No. {
Architect/Designer's Address
Architect/Designees E-mail Address
City
State
Zip I Telephone
F 5. Engineer's Name
Last'
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State �
Zip Telephoned
FX 6. Contractor's Name
Last CASEY First IMONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK N
OCCUPANCY - GROUP
PLAN CHECK FEE $