HomeMy WebLinkAboutF2024-0044 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application (r. °m
City of Newport Beach - Building Division
r Fire Sprinkler r" Fire Alarm r" Fire Misc
1. Project Address (Not mailing address)
1761 PORT MANLEIGH CIRCLE
Tenant Name MILLER RESIDENCE
2. Description of Work
FIRE SPRINKLERS
40 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 $ 4000
# Stories t
r 3. Owner's Name
Last
First F—
Owner's Address
Owner's E-mail Address
City
State F_
Zip F— Telephone—
r— 4. Arch itect/Designer's
Name Last
First— Lic.
No.F
Archltect/Designer's Address
Architect/Designer's E-mail Address
City �—
State F
Zip F Telephone—
r 5. Engineer's Name
Last
First Lic. No. F
Engineer's Address
Engineer's E-mail Address
City �--
State F—
Zip � Telephoned
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
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $