HomeMy WebLinkAboutF2019-0449 - Permit ApplicationPrint Form <IFaPN
Worksheet for Fire Permit Application °r
-- -- City of Newport Beach -Building Division ;,
Please print 3 copies ��
Associated Building Permit #
r Fire Sprinkler r Fire Alarm
r Fire Misc N I
1. Project Address (Not mailing address) Floor Suite No
1608 W.00EAN FRONT
Tenant Name MILLER RESIDENCE # Units
2. Description of Work
Use
FIRE SPRINKLERS
46 HEADS
Valuation $ 4600-00
Extg Sq Ft 7—New/Added Sq Ft � Total Sq Ft �-
# Stories I-
r New r Add r Alter � Demo
Check Appropriate Box for Applicant/Notification
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r 3. Owner's Name
Last i First
Owner's Address
Owner's E-mail Address
City �
State Zip F— Telephone-
r 4. Architect/Designer's
Name Last First I Lic. No.I
Architect/Designer's Address
Architect/Designer's E-mail Address
City f
State F Zip F— Telephone—
r 5. Engineers Name
Last First 7— Lic. No. F
Engineer's Address
Engineer's E-mail Address
City
State F Zip TelephoneF
r 6. Contractors 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 HABRA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.�
TYPE OF CONSTRUCTION G2OI' Le_*,) PLAN CHECK NO. 1-1 I=✓' Z� 1
OCCUPANCY - GROUP
i . C?l qcj PLAN CHECK FEE $
-i, ,. .I I(b c-__ 1Z n G