HomeMy WebLinkAboutF2021-0166 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building tDivision n
Please print 3 copies�Il /. �I W U
Associated Building Permit # F Fire Sprinkler Fire
Alarm F- Fire Misc
1. Project Address (Not
14 39TH ST
Tenant Name SALTER RESIDENCE
2. Description of Work
FIRE SPRINKLERS
35 HEADS
Extg Sq Ft �� New/Added Sq Ft E77-7 Total Sq Ft
F New ❑ Add F Alter r- Demo
Check Appropriate Box for Applicant/Notification
��EwPoRr
0
3
�</LORR�P
Floor Suite No
# Units
Use j
Valuation $ 3500 I
# Stories 13
❑ 3.Owner's Name Last
j First
Owner's Address
I
Owner's E-mail Address
City — -
i
State
Zip F7-:--- 7 Telephoned
4. Architect/Designer's Name
Last _ First �� Lic. No.
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
i
City _
State F7 _7
Zip F7___7 Telephone
5. Engineer's Name Last
First i Lic. No.
Engineer's Address
Engineer's E-mail Address
_ —,J
--J
City
State F_
Zip Telephone
_
—
FI6. Contractor's Name Last [CAS
First MONTY Lic. No. 876004 j Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA State CA
Zip 90631 J Telephone 714 476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
�,/i��rt _�)
rlit PLAN CHECK FEE $