HomeMy WebLinkAboutF2022-0448 - 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)
226 VIA ITHACA
Tenant Name NEW RESIDENCE
2. Description of Work
FIRE SPRINKLERS
31 HEADS
r Fire Sprinkler r Fire Alarm r Fire Misc
Extg Sq Ft r— New/Added Sq Ft F_ Total Sq Ft
Ix New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notif!cation
Floor Suite No
# Units �—
Use
Valuation $ 3100
# Stories
F- 3. Owner's Name
Last lam' �� First I Y6
l�
Owner's Address
Owners E-mail Address
City
State F_ Zip Telephoned
4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
City � �
State F_ Zip F— Telephoned
F_ 5. Engineer's Name
Last First F_ Lic. No.
Engineers Address
Engineers E-mail Address
City
State F_ Zip F— Telephoned
r 6. Contractor's Name
Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractors E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City I LAHABARA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
�.�. PERMIT NO —
TYPE OF CONSTRUCTION
PLAN CHECK NO.
14
OCCUPANCY - GROUP
PLAN CHECK FEE $