HomeMy WebLinkAboutF2018-0665 - Permit ApplicationF?�l67 Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# X'I a� R 22ci3 j
F>7� Fire Sprinkler r Fire Alarm r Fire Misc
U
1. Project Address (Not mailing address)
Floor
Suite No
616 ACACIA
—I! F77
State Zip —! Telephone!
------------
Tenant Name NEW RESIDENCE
# Units
Architect/Designer's Address
Architect/Designees E-mail Address
City
2. Description of Work
r' S. Engineer's Name Last
First F777-77 Lic. No.
Engineer's Address
Use
City
FIRE SPRINKLERS 36 HEADS
[j 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
--
Valuation $
3,600
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
State CA Zip 90631 Telephone 714 476-5370
—
PERMIT NO.%D1`6 • OF�(05
# Stories
New Add n Alter F_ Demo
OCCUPANCY- GROUP
PLAN CHECK FEE $
Check Appropriate Box for Applicant/Notification
r', 3. Owner's Name Last
First
-......-
.
Owner's Address
Owner's E-mail Address
City
State Zip —! Telephone!
n 4. ArchitecUDesigner's Name Last
- First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State F—Zip I. __ TelephoneF777777
r' S. Engineer's Name Last
First F777-77 Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F Zip F— Telephone
[j 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 714 476-5370
OFFICE USE ONLY
PERMIT NO.%D1`6 • OF�(05
TYPE OF CONSTRUCTION
( PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $