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Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
FZO Z O -04 ?EW�'OaT
p4 6
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V(' e — -Ls li F_ Fire Sprinkler r Fire Alarm 5? Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
2200 Newport Blvbd
�—
F
fhe Crab Cooker
# Units
F
Tenant Name
First F_ Lic.
No. F—
2. Description of Work
Architect/Designer's E-mail Address
_
Install 3 UI 300 Ansul Hood suppression systems
Use �—
r 5. Engineer's Name Last
Valuation $
12,000.00
Extg Sq Ft F— New/Added Sq FtTotal Total Sq Ft ��--
City State
Zip r—.--; Telephoned—
# Stories 1
R New r"' Add r Alter r Demo
Class F16
Contractor's Address
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last i
First F
Owner's Address
Owner's E-mail Address
City F_ State f'_--
Zip TelephoneF�
F_ 4. ArchitectlDesigner's Name Last
First F_ Lic.
No. F—
Architect/Designees Address
Architect/Designer's E-mail Address
City I— State F_
Zip F_ Telephoner
r 5. Engineer's Name Last
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City State
Zip r—.--; Telephoned—
R 6. Contractor's Name Last Hedrick First Richard Lic. No. 25132
Class F16
Contractor's Address
Contractor's E-mail Address
13309 Central Ave.
richard@hedrickfireprotection.com
City Chino State CA
Zip 91710 Telephone9515157866
OFFICE USE ONLY
PERMIT NO.
04
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP �t /
�� PLAN CHECK FEE $