HomeMy WebLinkAboutF2020-0476 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
2336 PORT LERWICK
Tenant Name NGUYEN RESIDENCE
2. Description of Work
IFIRE SPRINKLERS
Extg Sq Ft r— New/Added Sq Ft F
(X New F Add F_ Alter i— Demo
jX Fire Sprinkler r Fire Alarm F Fire Misc
%.necrc appropriate rsox for ApplicanVNotitication
I.-L---- -, - -
Floor Suite No
# Units F—
Use
Valuation $ 3400
Total Scl Ft �—
# Stories I-
F 3. Owner's Name Last
�— First F—
Owner's Address
Owner's E-mail Address
City [`
State �— Zip �— TelephoneF--_--
r 4. Arch itect/Designer's Name
---
Last First F— Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State F— Zip F— Telephone[—
F 5. Engineer's Name Last
First F-- Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City �—
State F Zip F-- Telephoner_—_
FX- 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. 0`1'lb
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $