HomeMy WebLinkAboutF2023-0167 - Permit ApplicationPrint Form
Please print 3 copies
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Associated Building Permit #
Ix Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
2515 BLUE WATER DR
F_
F_
Tenant Name KISHEK RESIDENCE
# Units
F
2. Description of Work
FIRE SPRINKLERS
Use
39 HEADS
Extg Sq Ft r New/Added Sq Ft � Total Sq Ft
Valuation $ 3900
# Stories
F
r New r Add F-AlterF-Demo
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State 7_
Zip F— Telephoned
F_ 4. Architect/Designer's Name Last
First Lic. No. F
Architect/Designer's Address
ArchitecVDesigner's E-mail Address
City
State F_
Zip F__ Telephoned
r 5. Engineer's Name Last
First F— Lic. No.
Engineer's Address
Engineers E-mail Address
City
State F
Zip F— Telephoned
RIB. Contractor's Name Last CASEY
First FMONTY 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 714-4765370
OFFICE USE ONLY
PERMIT NO. Y-5YZ3 a!Ig %
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TYPE OF CONSTRUCTION
v
% PLAN CHECK NO.
OCCUPANCY - GROUP
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PLAN CHECK FEE $