HomeMy WebLinkAboutF2024-0081 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
127 AGATE AVE
Tenant Name AGATE REMODEL
2. Description of Work
FIRE SPRINKLERS
22 HEADS
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
FX_ New F_ Add r" Alter I— Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use
Valuation $ 2200
# Stories F
F 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F_
Zip F- Telephone
r 4. Architect/Designer's Name
Last
First 7-- Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—
Zip F Telephoned
F_ 5. Engineer's Name Last
First— Lic. No.
�—
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip F_ Telephoned
r 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 HABRA
State CA
Zip 90631 Telephone 714-476-53700
OFFICE USE ONLY
PERMIT NO. FL°Z I `
6'J, t
TYPE OF CONSTRUCTION
1
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $