HomeMy WebLinkAboutF2023-0442 - 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)
23 CANYON PEAK
Tenant Name JAFARI RESIDENCE
2. Description of Work
FIRE SPRINKLERS
25 HEADS
(X Fire Sprinkler r— Fire Alarm r Fire Misc
Extg Sci Ft F New/Added Sci Ft Total Sci Ft
r New r Add r Alter F Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 2500
# Stories I -
I— 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City �
State F_
Zip F_ Telephone[—
F 4. Architect/Designer's Name Last
First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
city
State I
Zip �— Telephone—
r 5. Engineer's Name Last F
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State I
Zip F_. Telephone
ix 6. Contractor's Name Last CASEY
First MOiVTY 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 9F0631 Telephone 714-476-5370
OFFICE USE ONLY
QI PERMIT NO. 1� 7%J Vrty
TYPE OF CONSTRUCTION
PLAN CHECK NO. �GY 23 `2Zb
OCCUPANCY- GROUP
O` D� PLAN CHECK FEE $