HomeMy WebLinkAboutF2021-0426 - Permit ApplicationWorksheet for Fire Permit Application
r , ptir)t Fottn City of Newport Beach - Building Division
Please print 3 copies 23 I Z vC J
Associated Building Permit # [', Fire Sprinkler r Fire Alarm
1. Project Address (Not
400 40TH ST
Tenant Name KEIRSTEAI
2. Description of Work
FIRE SPRINKLERS
42 HEADS
address)
/ SNOW RESIDENCE
Extg Sq Ft I New/Added Sq Ft F_ Total Sq Ft
F, New r, Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
U S
G<�paN�P
[` Fire Misc
�Floor Suite No
# Units 177
Use V_
UV
v _(r2Z
Valuations 4200
# Stories
inforguatoon
F7 3. Owner's Name Last j G First
Owner's Address
Owner's E-mail Address
-----
city
State �— Zip P
__ —' hone Tele __ --- ---
(_j 4. Architect/Designer's Name Last
First F—' Lic. No. ji
_ — _ --
ArchitecUDesigner's Address
Architect/Designees E-mail Address
City
State Zip �' Telephone
rl 5. Engineer's Name Last
First I Lic. No. �I
Engineer's Address
Engineers E-mail Address
City
State �— Zip �— Telephone[?
ri 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class F7
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA J
State CA Zip 90631 i Telephone 714-476 5370
PERMIT NO.
OFFICE USE ONLY
""
TYPE OF CONSTRUCTION
PLAN CHECK NO. v
OCCUPANCY - GROUP
,✓ n1 DJ PLAN CHECK FEE $