HomeMy WebLinkAboutF2021-0534 - Permit ApplicationM,
07
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
LOT 74 2155 ANDOVER LANE
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
fX Fire Sprinkler j-; Fire Alar2DZr7. F05 isc
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OF RESIDENTIAL FIRE SPRINKLERS -M H„_ 1_
Extg Sq Ft New/Added Sq Ft
F��� Total Sq Ft 3,295
jXj New I Add F_ Alter ( Demo
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name"-- - -
Last
Owner's Address
City F
State F�
4. Arch itect/Designer's Name
First F�
Owner's E-mail Address
Zip F� Telephone
Last I _. First F
Architect/Designer's Address --
City �— v
State M
Architect/Designer's E-mail Address
Floor
# Units
Suite No
Use IRESIDENTIAL
Valuation $ $2,208.00
#Stories 1 -
Lic.
Zip f, Telephonel�
(' 5. Engineer's Name Last j�
I
Engineer's Address
City
State
f)Z 6. Contractor's Name
First —,
Lic. No.
Engineer's E-mail Address III
Zip F� Telephonef -------�-
Last BISHIP First JAMIE ; Lic. No, 684600 Class C 16
Contractor's Address
705 E. HARRISON STREET #200 Contractor's E-mail Address
jamieb@fireinc.net
City CORONA State CA
Zip 92879 Telephone 951-272-2522
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO. �-Z021
PLAN CHECK NO.
PLAN CHECK FEE $