HomeMy WebLinkAboutF2019-0335 - Permit ApplicationForm „a
Worksheet for Fire Permit Application
Pdint
F.� l�f I �3�City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I FX_ Sprinkler F, Fire Alarm rFire Misc
U
1. Project Address (Not mailing address)
Floor
Suite No
225 VIA LIDO SOUD
Owner's Address
Tenant Name CURCI RESIDENCE
#Units
City
2. Description of Work
Zip Telephone
-__ ......... ... . .
r 4. Architect/Designer's Name Last
Use
First F_ Lic. No.
FIRE SPRINKLERS 47 HEADS
- ---
--
Valuation $
4,700
Extg Sq Ft New/Added Sq Ft Total Sq Ft F
F5. Engineer's Name Last
-Add
# Stories 1
rl New r (-! Alter r Demo
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State
Zip Telephone
-__ ......... ... . .
r 4. Architect/Designer's Name Last
First F_ Lic. No.
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City
State
Zip Telephone
F5. Engineer's Name Last
�', First Lic No. r�!
Engineer's Address
Engineer's E-mail Address
City
- - -',
State
Zip Telephone,
-
r-,6. Contractor's Name Last Casey
First Monty Lic. No. 876004
Class C-16 j
Contractor's Address
Contractor's E-mail Address
1101 Kingston Dr
fireproofmc@gmail.com
City La Habra
State CA
Zip 90631 Telephone714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
' PLAN CHECK FEE $
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