HomeMy WebLinkAboutF2023-0006 - Permit ApplicationPrint Form Worksheet for Fire Permit Application o�"'�Rm
City of Newport Beach - Building Division
Please print 3 copies Yoa°"
Associated Building Permit # r Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
1 COLLINS ISLAND
Tenant Name PRIVATE RESIDENCE
2. Description of Work
FIRE SPRINKLERS
47 HEADS
Extg Sq Ft F-- New/Added Sq Ft F— Total Sq Ft
Ix New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 4700
# Stories I3
r 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City F_—
State F_
Zip F— Telephoned
IW 4. Architect/Designer's Name Last
First F_ Lic. No.
Architect/Designees Address
ArchitectlDesigner's E-mail Address
City
State
Zip F Telephoned
5. Engineer's Name
Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F_ Telephoned
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 9F0631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. ftt-I's, b00(o
TYPE OF CONSTRUCTION
PLAN CHECK NO. IbUll ' 001 i
OCCUPANCY - GROUP
��7 a q I h
PLAN CHECK FEE $
X�14-Ir"