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Associated Building Permit #
Worksheet for Fire Permit Application oF�`'�°>a
City of Newport Beach - Building DivisionIr
4
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Fire Sprinkler j— Fire Alarm (— Fire Misc
1. Project Address (Not mailing address)
333 HOLMWOOD DR
Tenant Name ATKINS RESIDENCE
2. Description of Work
FIRE SPRINKLERS
47 HEADS
Extg Sq Ft F— New/Added Sq Ft [-- Total Sq Ft
fX New r Add r- Alter r Demo
NI'IURMrraaco UVA rvr m lipllcanUIVOLITIcation
Floor Suite No
# Units �—
Use
Valuation $ 4700
# Stories I3
F 3.Owner's Name Last
First
Owner's Address
Owner' mail Address
city
State �— Zip [_ Telephoned—
fW 4. Architect/Designer's Name
Last First F— Lic. No. i —
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State r--._ Zip �— Telephone[—
1- S. Engineer's Name Last—�
First F Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State �— Zip [_ Telephoned
Fx 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
is PERMIT NO. bU
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
i CIA l�[ • UJM� PLAN CHECK FEE $