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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler j` Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
1201 HIGHLAN DR
Tenant Name NEW REMODEL
2. Description of Work
FIRE SPRINKLERS
33 HEADS
Extg Sq Ft F New/Added Sq Ft F— Total Sq Ft
IX New r Add I— Alter r Demo
Check Appropriate Box for Appiicant/Notification
Floor Suite No
# Units I
Use
Valuation $ 3300
#Stories �1
F 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City I
State � Zip �— TelephoneF—
F 4. Architect/Designer's Name
Last First F- Lic. No. �—
ArchitectlDesigners Address
Architect/Designers E-mail Address
City
State F_ Zip F Telephone
(— 5. Engineer's Name Last
F First F_ Lic. No.
Engineers Address
Engineer's E-mail Address
City
State F Zip F_ Telephone
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 HABARA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.�
TYPE OF CONSTRUCTION
PLAN CHECK NO. I 135LZO Z
OCCUPANCY- GROUP
PLAN CHECK FEE $ 22Z `Utl