HomeMy WebLinkAboutF2019-0555 - Permit Application— Worksheet for Fire Permit Application
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� OGGJGCity of Newport Beach - Building Division
Please print 3 copies //
Associated Building Permit # L F fire Sprinkler ❑ Fire Alarm [I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
I II—
20292 SPRUCE AVE F77
_-- - ___.__l __.._._
# Units
Tenant Name CABLE RESIDENCE J
2. Description of Work
Use
State Zip �l Telephone
FIRE SPRINKLERS I
Name Last First L Lic. No.
20 HEADS
---- --- -.._.I
Valuation S 2000 i
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E#g Sq;Ft New/Added Sq Ft Total Sq Ft
F77777
State I Zip �— Telephone -
# Stories
FI; New [Add [Alter [
tDemo
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last First
Owner's Address
Owners E-mail Address
City
State Zip �l Telephone
[ 4. ArchitecVDesignees
Name Last First L Lic. No.
Architect/Designers Address
Architect/Designees E-mail Address
City
State I Zip �— Telephone -
[!, 5. Engineer's Name
Last First Lic. No. J
Engineer's Address
Engineer's E-mail Address
i
City State Zip jj Telephone
F 6. Contractor's Name
Last CASEY First MONTY= Lic. No. 576004 Class[C-16�
Contractors Address
Contractors E-mail Address
9101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
StateCA - j Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
l.\
TYPE OF CONSTRUCTIONS
X / PLAN CHECK NO.
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OCCUPANCY- GROUP
`� � PLAN CHECK FEE $
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