HomeMy WebLinkAboutF2019-0355 - Permit ApplicationWorksheet for Fire Permit Application dEWPpRT
F261q-03.55 Citi' of Newport Beach - Building Division
ermit #
r Fire Sprinkler r Fire Alarm i- Fire Misc
mailing address)
er Dr
(ant Name INew Residence
2. Description of Work
Fire sprinklers
28 heads
Extg Sq Ft — New/Added Sq Ft Total Sq Ft F'
rX,New r Add r Alter Demo
Check Appropriate Box for Applicant/Notification
(-3.Owner's Name Last! R
_ __.-.- First
Owner's Address - '
Owner's E-mail Address
Floor Suite No
# Units
Use F
Valuation $ 2800.00
#Stories I2
__-
City State r_ ��
Zip [' Telepho-
r 4. Architect/Designer's Name Last
First �— Lic. No.
rc dect/Designer's Address
rchitecUDesigner's E-mail Address
City State _
- Zip �— Telephone
Last Firs
�—
En 5. Engineer's Name L
r t
- Lic. No.
ginger's Address
Engineer's E-mail Address
City
State �-
- - Zip � Telephoner;
rj 6. Contractor's Name Last Monty
First Casey Lic No 87600
Contractor's Address
1101 Kingston Dr
City La Habra State CA
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Class C-16
Contractor's'' lail Address
iTireproofMC@gmail.com
Zip 90631 Telephone714-476-5370
PERMIT NO.f2I3-0` 5, -
\f0 PLAN CHECK NO.
✓ PLAN CHECK FEE $