HomeMy WebLinkAboutF2022-0065 - Permit ApplicationWorksheet for Fire Permit Application
Print Form
City of Newport Beach - Building Division
Please print 3 copies
a ,.
Associated Building Permit#
lU)-Z_ Fire Sprinkler rFireAlarm
rFireMisc
1. Project Address (Not mailing address)
Floor
Suite No
211 IRIS AVE
Tenant Name DUNCAN RESIDENCE
# Units
2. Description of Work
FIRE SPRINKLERS
Use j
lam°
38 HEADS
Valuation $ 3800
Extg Sq Ft New/Added Sq Ft F Total Sq Ft
F
`V ,s
# Stories
j
New )— Add I— Alter r Demo
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name
Last � First
Owner's Address
Owner's E-mail Address
City �—
State F_ Zip Telephoned
_. 4. Architect/Designor's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State F Zip [_ Telephoned
(— 6. Engineer's Name
Last � First [_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip F_ Telephoned
CK 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
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
n Z _ �� j PLAN CHECK FEE $