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HomeMy WebLinkAboutF2023-0371 - Permit ApplicationPrint Form Please print 3 copies Associated Building Permit# Worksheet for Fire Permit Application eggCity of Newport Beach - Building Division �— ri Fire Sprinkler [1 Fire Alarm r Fire Misc 1. Project Address (Not mailing address) Floor Suite No TERRACE 1130 DOLPHIN - - - - - - - Tenant Name ANE RESIDENCE #Units LCO 2. Description of Work FIRE SPRINKLERS Use 21 HEADS Valuation $ 2100 Extg Sq Ft I New/Added Sq Ft Total Sq Ft - # Stories F Ix New rl Add r Alter � Demo Check Appropriate Box for ApplicanVNotification I nf�rm ��i�n r 3.Owner's Name Last First. Owner's Address Owner's E-mail Address City - State F-j Zip F Telephoner (-. 4. Architect/Designer's Name Last First F Lic. No. F Architect/Designer's Address Architect/Designer's E-mail Address City __] State F Zip F Telephoned �j 5. Engineer's Name Last First Lic. No. Engineer's Address Engineer's E-mail Address City j State Zip F Telephone IX1 6. Contractor's Name Last CASEY First MONTY Lic No. 676004 Class C-16 Contractor's Address Contractor's E-mail Address 1101 KINGSTON DR FIREPROOFMC@GMAIL.COM City LA HABARA State CA Zip 90 331 Telephone 714-476-5370 OFFICE USE ONLY a� P�yO?Afi'�/Xrtsi.y� ` PERMIT NO.'N�h e� TYPE OF CONSTRUCTION M iiLgv 'Lv1 PLAN CHECK NO. 9t)�ji77/{7 `61 7 „/ OCCUPANCY - GROUP f Y W PLAN CHECK FEE $