HomeMy WebLinkAboutF2021-0026 - Permit ApplicationWorksheet for Fire Permit Application
Print Form
City of Newport Beach - Building Division
Please print 3 copies<oa '
Associated Building Permit # rX Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address Not mailing address)
301 Milford
Tenant Name IPrichard Residence
2. Description of Work
Fire Sprinkler system-70 Heads
Floor Suite No
I'
# Units F
Use
Valuation $ 6000
Extg Sq Ft F_New/Added Sq Ft F_Total Sq Ft
# Stories 3
Fx— New I Add j— Alter F_Demo
Check Appropriate Box for Applicant/Notification
r- 3.Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F_
Zip F_ Telephoned---
(— 4. Architect/Designer's Name
Last First �— -- Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_
Zip F_ Telephoned
F_5. Engineer's Name Last Mitchell
First Brent Lic.No.�
Engineer's Address
Engineer's E-mail Address
Same as below
City
State F_
Zip F_ Telephoned
FX— 6. Contractor's Name Last California Fire Protection
First F Lic. No. 1016781 Class C-16
Contractor's Address
Contractor's E-mail Address
647 Camino De Los Mares#108
stacee@cafireprotection.com
City San Clemente
State CA
Zip 92673 Telephone 949-770-5371
OFFICE USE ONLY
PERMIT NO. few Dom,
TYPE OF CONSTRUCTION
PLAN CHECK NO. pt3(0'
OCCUPANCY - GROUP
PLAN CHECK FEE $ 21�
S 3 i 2_ Ici
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