HomeMy WebLinkAboutF2020-0449 - Permit ApplicationWorksheet for Fire Permit Application g oN0,
Print Form City of Newport Beach - Building Division q ,��o - oq"t t f
Please print 3 copies 4� boa "
Associated Building Permit # r Fire Sprinkler ' Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
3805 SANDUNE LANE
r—'
State F Zip Telephone
Tenant Name VVILLIAMRESIDENCE
#Units
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City �
State F—, Zip F� Telephone
2. Description of Work
---
First Lic. No.
Engineer's Address
FIRE SPRINKLERS
Use
1'
30 HEADS
Contractor's Address
Contractor's E-mail Address
_
Valuation $
3000
Extg Sq Ft F New/Added Sq Ft Total Sq Ft
OFFICE USE ONLY
?CA
���.3'C./ " (� PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
# Stories
r New r, Add r Alter r Demo
PLAN CHECK FEE $
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F Zip Telephone
F_ , 4. Architect/Designees Name Last
First F_ Lic. No. F
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City �
State F—, Zip F� Telephone
r 5. Engineer's Name Last
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First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State I— Zip F Telephoned
FX_ 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 Zip 90631 Telephone 71 4-476-5370
OFFICE USE ONLY
?CA
���.3'C./ " (� PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
`'PLAN CHECK NO.
(2 - �'
PLAN CHECK FEE $