HomeMy WebLinkAboutF2020-0360 - Permit Application-F?tint.F.orm
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application o�PoRe
City of Newport Beach - Building Division 1 1�j� � U
�itJ oar.
rl, Fire Sprinkler F Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
11 TORREY PINES LANE
- - - ----
Tenant Name MOORHEADRESIDENCE #Units F77
2. Description of Work
State Zip Telephone
F_ 4. Architect/Designer's Name Last
Use
FIRE SPRINKLERS
67 HEADS
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----- - - - ---'
Extg Sq Ft F—- New/Added Sq Ft F Total Sq Ft
Valuation$ 6,700 - J
r; New Add rAlter r Demo
#Stories I
Check Appropriate Box for Applicant/Notification
Informatm-
3.Owner's Name Last �Y¢�t'Gte � First
Owner's Address
Owner's E-mail Address
City
State Zip Telephone
F_ 4. Architect/Designer's Name Last
- -- - First —'I Lic. No. —,-
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
i
- -
city
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StateF777 Telephonel
[! 5. Engineer's Name Last
First Lic. No.'i
Engineer's Address
Engineer's E-mail Address
City i
State Zip—Telephone
rj 6. Contractor's Name Last CASEY
First MONTY Lic. No. 7fo0o kassF_
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
— - —
FIREPROOFMC@GMAIL.COM
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City LA HABRA
State CA Zip 90631 Telephone 714 476 5370
OFFICE USE ONLY
XX $] PERMIT NO. �% • V�%�O
TYPE OF CONSTRUCTION _
PLAN CHECK NO. 1172 .20%
OCCUPANCY- GROUP
V W �� • PLAN CHECK FEE $