HomeMy WebLinkAboutF2019-0306 - Permit ApplicationWorksheet for Fire Permit Applicati ji usVE14,
0/,vd2` ity of Newport Beach -Building Divisipn yPlease print 3 copies(/
Associated Building Permit # Fire Sprinkler r Fi � Alarm r" Fire Misc
1. Project Address (Not mailing address) Ll g Floor Suite No
1226 KEEL DR 2
Tenant Name TIPTONRESIDENCE #Units
2. Description of Work
_
State F
Use
FIRE SPRINKLERS 19 HEADS
- - -'
First F_ Lic. No.
Valuation $ 1,900
Extg Sq Ft F New/Added Sq Ft � Total Sq Ft
Architect/Designer's E-mail Address
City I
# Stories 2
FX- New r- Add r Alter F- Demo
F_ 5. Engineer's Name Last
Check Appropriate Box for Applicant/Notification
(-
3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City �Y
State F
Zip Telephoner
4. Architect/Designer's Name Last
First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—
zip[—Telephoned
F_ 5. Engineer's Name Last
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State 2—
Zip F TelephoneF
F-!6. 6. Contractor's Name Last CASEY First ON
MTY Lic. No. 876004 Class C16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA
Zip 90631 Telephone7144765370
OFFICE USE ONLY PERMIT NO. 0
TYPE OF CONSTRUCTION
�%f n(' C�i3�
PLAN CHECK NO. L
OCCUPANCY- GROUP
PLAN CHECK FEE $