HomeMy WebLinkAboutF2020-0284 - Permit Applicationf �Print�orrn'^
Worksheet for Fire Permit Application o�EW��
City of Newport Beach - Building Division 1'Z5 I
Please print 3 copies -ORBy c<,.oa
Associated Building Permit #
Fx_� Fire Sprinkler f— Fire Alarm ri Fire Misc
1. Project Address (Not mailing address) Floor Suite No
417 E. BAY AVE
Tenant Name NEW RESIDENCE # Units
2. Description of Work
Use
FIRE SPRINKLERS
33 HEADS
I�
First Lic. No.
�I II I 777
Extg Sq Ft � New/Added Sq Ft F—Total Sq Ft
Valuation $ 3300-
City
# Stories I
FX, r Add r, Alter r Demo
Engineer's Address
Check Appropriate Box for Applicant/Notification
(-' 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State �— Zip F_— TelephoneF
1 4. Architect/Designer's Name Last
I�
First Lic. No.
�I II I 777
Architect/Designees Address
Architect/Designer's E-mail Address
�I
City
State—; Zip F— Telephone
[i 5. Engineer's Name Last First Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
- --
Stater Zip Telephone
F>� 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 47670
-53
OFFICE USE ONLY
PERMIT NO. Wo ULU
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
J
'� �'� PLAN CHECK FEE $ v