HomeMy WebLinkAboutF2023-0457 - Permit ApplicationWorksheet for Fire Permit Application
QUM
Print Form City of Newport Beach - Building Division Please print 3 copies
Associated Building Permit# (X Fire Sprinkler [_ Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
513 ACACIA
Tenant Name IBIRE II, LLC
2. Description of Work
FIRE SPRINKLERS
38 HEADS
Extg Sq Ft F— New/Added Sq Ft F— Total Sq Ft
r New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units I —
Use
Valuation $ 3800
# Stories [3
F- 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
City
State F_
Zip �— Telephone —
if
r 4. Architect/Designer's Name Last
First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �—
Zip Telephoned
r 5. Engineer's Name
Last
First F— Lic. No. F
Engineer's Address
Engineer's E-mail Address
City
State �—
Zip �— Telephone—
r 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 HABRA
State CA
Zip 90631 Telephone 714-476-5370
PERMIT NO. �1n t�
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PLAN CHECK NO. TGUla•2�b12Z
OCCUPANCY - GROUP
"
PLAN CHECK FEE $