HomeMy WebLinkAboutF2019-0163 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
X201 08 - 0 l U 3
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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Fire Sprinkler FX_ Fire Alarm F Fire Misc
1. Project Address (Not mailing address) Floor Suite No
3303 Via Lido Duplex r F—
Tenant Name #Units F
III
2. Description of Work
Use RESIDENTIAL
INSTALLATION OF RESIDENTIAL FIRE SPRINKLER MONITORING SYSTEM 3 DEVICES.
I
Valuation $ $2,000
Extg Sci Ft New/Added Sci Ft Total Sci Ft 3,527
Architect/Designer's E-mail Address
City;
#Stories I3
Add
rXJ New rf F-1 Alter rl Demo
Last Lic. No.
F
Check Appropriate Box for Applicant/Notification
[; 3. Owner's Name
Last j First
Owner's Address
Owner's E-mail Address
City
_ State �' Zip— Telephone,
4. Architect/Designer's
Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City;
State �I,Zip Telephone-
(-,I . Engineer's Name
9
Last Lic. No.
F
Engineer's Address
l/ \
Engineer's E-mail Address
city
City
I State Zip TelephoneF
6. Contractor's Name
Last rODGERS First CHRIS Lic. No. 854971 Class C-10
Contractor's Address
Contractor's E-mail Address
705 E. HARRISON STREET #200chrisr@fireinc.net
City CORONA
i State CA Zip 92879 Telephone 800-915-3473
OFFICE USE ONLY
��1�� PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
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OCCUPANCY- GROUP��,
PIAN CHECK FEE $