HomeMy WebLinkAboutF2021-0126 - Permit ApplicationWorksheet for Fire Permit Application
nt Form City of Newport Beach - Building Division
ease print 3 copies YU/
Associated Building Permit # r Fire Sprinkler r Fire Alarm r Fire Misc
e'EW PpRr
1. Project Address (Not mailing address) Floor Suite No
201 OPAL AVE r__ F__
Tenant Name 201 OPAL LLC # Units F
2. Description of Work
FIRE SPRINKLERS Use
27 HEADS
Valuation $ 2700
Extg Sq Ft � New/Added Sq Ft F_ Total Sq Ft r
r New [— Add r Alter r Demo
t.:necic Appropriate Box for Applicant/Notification
# Stories 13l
F 3. Owner's Name Last
First F—
Owner's Address
Owner's E-mail Address
City
State F
Zip F TelephoneF—
F 4. Arch itect/Designer's Name
Last First F Lic. No.
�—
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State F_
Zip F_ TelephoneF_
F S. Engineer's Name Last
First 7— Lic. No.
�—
Engineers Address
Engineer's E-mail Address
City
State F
Zip F— Telephoned
R—6. Contractor's Name Last CASEY
First [MONTY Lic. No. 876004 Class F16
Contractors 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
L
WV PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
G
OCCUPANCY - GROUP
1✓ �1.� Ct%)
/} PLAN CHECK FEE $