HomeMy WebLinkAboutF2021-0533 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Divisio,.n�71
Please pant 3 copies rl � A���� J
Associated Building Permit# ��1a�q'J�I�bI IX Fire Sprinkler I—, Fire Alarm I—FireMisc
1. Project Address (Not mailing address) Floor Suite No
11 LOT 73 2153 ANDOVER LANE Fi �—
Tenant Name _ # Units
2. Description of Work
Use RESIDENTIAL
INSTALLATION OF RESIDENTIAL FIRE SPRINKLERS �J
Extg Sq Ft �', New/Added Sq Ft—, Total Sq Ft 2,499
Valuation $ 51,843.00
# Stories I
r' New r Add r Alter ["- Demo
Check Appropriate Box for Applicant/Notification
I
3. Owner's Name Last First F—
Owner's Address Owner's E-mail Address
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City _ _ State F__ ZipF----� Telephone
r 4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State _. Zip (-- Telephoner
---.._-
j 5. Engineer's Name Last FirstLic. No. I —,
Engineer's Address Engineer's E-mail Address
City 1 _., State F- Zip [_ Telephone F_
(x6. Contractor's Name Last BISHIP First(J�AMIE� Lic. No. 684600 Class C-16
I F
Contractor's Address Contractor's E-mail Address
705 E. HARRISON STREET #200 jamieb@fireinc.net
City rCORONA StateCA Zip 92879 Telephone 51-272-2522
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NO. 202.1 - 650
PLAN CHECK NO. `,(?175.2.02(
PLAN CHECK FEE $