HomeMy WebLinkAboutF2021-0025 - Permit Applicationt FWorksheet for Fire Permit Application o�rEWPo
2Piorth
City of Newport Beach - Building Division
t w�� vraz;
Please print 3 copies
Associated Building Permit # r Fire Sprinkler r Fire Alarm rFire Misc
1. Project Address (Not mailing address)
Floor
Suite No
1741 PLAZA DEL SUR
I
State F777 Zip —' TelephoneF__I
Tenant Name MILLER REMODEL
# Units
Architect/Designer's Address
ArchitecttDesigners E-mail Address
City
Statei Zip [ Telephoned!,
2. Description of Work
FirstF--,', Lic. No.
Engineer's Address
Engineer's E-mail Address
Use
State Zip F Telephone
33 HEADS/ FIRE SPRINKLERS
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
- --------
Valuation $
3300
Extg Sq Ft �', New/Added Sq Ft F_Total Sq Ft ��,
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION mile
�w
PLANCHECKNO.OCCUPANCY-
# Stories
)(', New r, Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Inf^rma +inn
F,- 3. Owner's Name LastJ
' FirsI
t
Owner's Address
Owner's E-mail Address
City
State F777 Zip —' TelephoneF__I
F_ 4. Architect/Designer's Name Last
First �, Lic. No.—f
Architect/Designer's Address
ArchitecttDesigners E-mail Address
City
Statei Zip [ Telephoned!,
r, 5. Engineer's Name Last
9
FirstF--,', Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip F Telephone
[X! 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 HABA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION mile
�w
PLANCHECKNO.OCCUPANCY-
GROUP
/ PIAN CHECK FEE $