HomeMy WebLinkAboutF2021-0213 - Permit Application"Fd#;c„�s� r� z-.®ania j
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing address)
122 E BAY AVE —
Tenant Name JARCHULETA RESIDENCE
2. Description of Work
FIRE SPRINKLERS
8 HEADS
City of Newport Beach - Building Division _ o
0 ?A 3 oa a
�6 r Fire Sprinkler ❑ Fire Alarm Fire Misc
Extg Sq Ft — New/Added Sq Ft 7 Total Sq Ft
New [Add r—
j Alter [ Demo
Check Appropriate Box for Applicant/Notification
1_9__—_.._ _
Floor Suite No
# Units
Use
Valuation $ 8,000 _ Ji
# Stories 11
( 1 3.Owner's Name
Last — First -
Owner's Address
Owner's E-mail Address
City ----------------
State—' Zip Telephone[-
elephone4.
4.Architect/Designer's
Name Last FirstLic. No.
77
Architect/Designer's Address
Architect/Designer's E-mail Address
City ! --
State —�i ZipF____ TelephoneF_____7
5. Engineer's Name
Last —; FirstLic. No. l
-- L
Engineer's Address
Engineer's E-mail Address
CityState �! --
Zip J Telephone
j 6. Contractor's Name
Last CASEY — First MONTY Lic. No. 876004 Class C_76
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
I FIREPROOFMC@GMAIL.COM
City LA HABRA
! State CA —J, Zip90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. SKC0
OCCUPANCY- GROUP
� 2 I Boz, L� PLAN CHECK FEE $
0933- Z_0-7,.(