HomeMy WebLinkAboutX2020-2445 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division X Zd Z0
Please print 3 copies
Associated Building Permit # FXFire Sprinkler Fi Fire Alarm r- Fire Misc
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1. Project Address (Not mailing address)
Floor
Suite NO
28111OCEAN LANE
I
Owner's E-mail Address
Tenant Name MIKEN RESIDENCE
#Units
F77
r-, 4. ArchitectIDesignees
Name Last First Lic. No.
2. Description of Work
Use
Architect/Designer's E-mail Address
FIRE SPRINKLERS
42 HEADS
Zip F_ Telephoned—'
5. Engineer's Name
Last
Valuation $
4200
Extg Sq FtF New/Added Sq Ft Total Sq Ft
Engineer's Address
i
Engineer's E-mail Address
City
State '
Zip �', Telephoned',
rKi 6. Contractor's Name
Last JQASEY First MONTY Lic. No. 876004 Class C-16
#\Stories
FX-, New F-, Add F -i Alter 17 Demo
Contractor's E-mail Address
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FIREPROOFMC@GMAIL.COM
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City LA HABRA
Check Appropriate Box for Applicant/Notification
f- 3. Owner's Name
Last
First
Owner's Address
Owner's E-mail Address
-_._ --
City
State
Zip Telephonel�,
r-, 4. ArchitectIDesignees
Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
I State
Zip F_ Telephoned—'
5. Engineer's Name
Last
First F7'; Lic. No.
Engineer's Address
i
Engineer's E-mail Address
City
State '
Zip �', Telephoned',
rKi 6. Contractor's Name
Last JQASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
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FIREPROOFMC@GMAIL.COM
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City LA HABRA
State CA
Zip 90631 i Telephone714-476-5370
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. Z 43'�
Z:L [ ' L
PLAN CHECK NO.
OCCUPANCY - GROUPQz
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PLAN CHECK FEE $
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