HomeMy WebLinkAboutF2024-0162 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # [! Fire Sprinkler r j Fire Alarm [I Fire Misc
1. Project Address (Not mailing address)
622 San Miguel Drive
Tenant Name haupain Bakery
2. Description of Work
jFire SprinklerTI (35) heads
Extg Sq Ft ,600 New/Added Sq Ft �I Total Sq Ft
[ j New j ll Add ri Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
F-I F-11
# Units �I
Use B
Valuation $ 12,100.00
# Stories
rj 3. Owner's Name Last
J First
Owner's Address
Owner's E-mail Address
City
State F_
Zip �Telephone
I— 4. Architect/Designer's Name Last
First- Lic. No.�
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F
Zip F77 Telephone
r- 5. Engineer's Name Last
l First J Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State �-
Zip �� Telephoned
-- eI - --
R 6. Contractor's Name Last aekel
First Steve Lic No. 599761 Class C36,10,16
Contractors Address
Contractor's E-mail Address
1170 E. Fruit Street
jaekel@firesafetyfirst.com
City anta Ana
State CA
Zip 2701 J Telephone 14-329-7110
OFFICE USE ONLY
/ � PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
j� .� PLAN CHECK FEE $