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HomeMy WebLinkAboutF2021-0532 - Permit ApplicationWorksheet for Fire Permit Application �0*i A, 0 City of Newport Beach -Building Division Please print 3 copies Associated Building Permit # XV I 30(�D r Fire Sprinkler f -" Fire Alarm (— Fire Misc 1. Project Address (Not mailing address) LOT 72 2151 ANDOVER LANE Tenant Name 1 2. Description of Work OF RESIDENTIAL FIRE SPRINKLERS 32 N Extg Sq Ft---, New/Added Sq Ft Total Sq Ft 2,916 _.._ ri New r, Add r Alter f Demo ."u ^PPI VIn lam Dort rur Appncanurvottttcation Floor Suite No Owner's Address I # Units — F Use RESIDENTIAL �Y Valuation $ $1,895.00 # Stories I - r 3. Owner's Name Last F� First Owner's Address _._,. Owner's E-mail Address City F� State �— Zip Telephone---- r 4. Arch itect/Designer's Name Last First F_Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address city State Zip l Telephone — f ", S. Engineer's Name Last F �First, Lic. No. Engineer's Address Engineer's E-mail Address City F---� � State F__ Zip F— Telephoner— S. Contractor's Name Last SHIP First JAMIE Lic. No. 684600 Class C-16 F F Contractor's Address Contractor's E-mail Address 705 E. HARRISON STREET#200 jamieb@fireinc.net City (CORONA State CA Zip 92879 Telephone 951-272-2522 OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO.®L �� OCCUPANCY- GROUP PLAN CHECK FEE $