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Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application o4�EWR>m
City of Newport Beach - Building Division � - '�
Fire Sprinkler r Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
302 KINGS RD
Tenant Name KING RESIDENCE
2. Description of Work
FIRE SPRINKLERS
67 HEADS
Extg Sq Ft F—New/Added Sq Ft F
New F_ Add F- Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 6700
Total Sq Ft
# Stories
F 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City � State
f
Zip F— Telephoned
F 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City � State
F_
Zip F_ Telephone
r- 6. Engineer's Name Last
First Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City � State
F_
Zip Telephoned
r 6. Contractor's Name Last CASEY
First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
IA HABARA State
CA
Zip 9F0631 Telephone 714-476-5370
'E USE ONLY
PERMIT NO.
OF CONSTRUCTION
PLAN CHECK NO. ,l
V
4NCY - GROUP
PLAN CHECK FEE $