HomeMy WebLinkAboutF2019-0654 - Permit ApplicationWorksheet for Fire Permit Application
t Form City of Newport Beach - Building Division
,ease print 3 copies 7
Associated Building Permit# Z010() -27Z r Fire Sprinkler Fire Alarm Fire Misc
1. Project Address (Not mailini
F----....... -
Tenant Name NEW RESIDENCE
2. Description of Work
FIRE SPRINKLERS 26 HEADS
Extg Sq Ft r New/Added Sq Ft
FX- New i- Add r Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use
Valuation $ 2600
Total Sq Ft
# Stories 2
r 3. Owner's Name Last
First F
Owners Address
Owner's E-mail Address
City
State F_
Zip F_ Telephoned
r 4. Architect/Designer's Name Last
First F_ Lic. No. F
Architect/Designer's Address
Architect/Designers E-mail Address
City
State F—
Zip F Telephoned
F_ 5. Engineer's Name Last
First Lic. No. F
Engineer's Address
Engineers E-mail Address
City
State F
Zip I-- Telephoned--
iX 6. Contractor's Name Last CASEY
First MONTY Lic. No. 876004
Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA
Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
�� G
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $