HomeMy WebLinkAboutF2019-0339 - Permit ApplicationWorksheet for Fire Permit Application
P7 nt Form -; City of Newport Beach - Building`` Division (�
Please print 3 copies y Z 4q 0 1— 1-0�q
Associated Building Permit # �(��?J rX, Fire Sprinkler r Fire Alarm r Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
1231 SAND KEY
Tenant Name #Units F
Owner's E-mail Address
2. Description of Work
State �_— Zip �— Telephone ��
INSTALLATION OF A NFPA 13 D FIRE SPRINKLER SYSTEM
Use
— —'
Valuation $ 5,000
Extg Sq Ft New/Added Sq Ft F Total Sq Ft f
State F_— Zip F—i Telephoned
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r, New r Add r Alter r Demo C3,
Stories I
Engineer's Address
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name
Last HAKES First /.'
Owner's Address
Owner's E-mail Address
City �_
State �_— Zip �— Telephone ��
r 4. Architect/Designer's
Name Last First;, Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City �—
State F_— Zip F—i Telephoned
[7, Engineer's Name
Last .First F___7— Lic No.
Engineer's Address
Engineer's E-mail Address
City
State F Zip I Telephone[,,-
elephone[r6.
r76.Contractor's Name
Last CASEY First MONTY Lic. No. 876004 ClassFc -16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DRIVE
fireproofmc@gmaii.com
City LA HABRA
- --
State CA Zip 90631 Telephone 714 476 5370
OFFICE USE ONLY
PERMIT NO. �- ton
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
��� 1 �'J , Q Z. 6 S PLAN CHECK FEE $