HomeMy WebLinkAboutF2023-0445 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
419 GOLDENROD AVE
Tenant Name 419 GOLDENROD LLC
2. Description of Work
FIRE SPRINKLERS
40 HEADS
Extg Sq Ft New(Added Sq Ft F Total Sq Ft
FXX, New F-1 Add F- Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units I
Use
Valuation $ 4000
# Stories F
3.Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State
Zip �— Telephone—
r 4. ArchitecUDesigner's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F——
State �—
Zip f Telephone5.
Engineer's Name Last
First �— Lic. No.I
Engineer's Address
Engineer's E-mail Address
City
State I—
Zip F_ TelephoneF
rX 6. Contractor's Name Last CASEY First MONTY 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 90631 Telephone 714-476-5370
OFFICE
PERMIT NO. y
OF CONSTRUCTION
/j � PLAN CHECK NO.
OCCUPANCY - GROUP
(/ PLAN CHECK FEE