HomeMy WebLinkAboutF2019-0131 - Permit ApplicationWorksheet for Fire Permit Application o"
Print Fprm City of Newport Beach -Building Divisir�^`MM
Associated Buildina Permit #
Please print 3 copies
Fire Sprinkler r harm arm Fire Misc
1. Proiect Address (Not mailing i
2204 WATERFRONT DR
Tenant Name IPAUTSCH RESIDENCE
2. Description of Work
SPRINKLERS 37 HEADS
Extg Sq Ft r New/Added Sq Ft
r', New r Add r Alter r Demo
Check Appropriate Box for ApplicanVNotification
Total Sq Ft �— —
(- 3. Owner's Name Last First
Floor Suite No
# Units
Use
Valuation $ 3700.00
# Stories
Owner's Address Owner's E-mail Address
City F� State �.— Zip F— Telephoner
4. Architect/Designer's Name Last First Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
Iry State r— Zip �— Telephoner�
Name Last CASEY First MONTY Lic No. 876004 class C-16
Contractor's E-mail Address
FIREPROOFMC@GMAIL.COM
State CA Zip 90631 Telephone714-476-5370
PERMIT NO. 4-U' M
&&C
A PLAN CHECK NO. .
(j PLAN CHECK FEE $