HomeMy WebLinkAboutF2020-0243 - Permit ApplicationWorksheet for Fire Permit Application
Pnrlf �4fm;< < City of Newport Beach - Building Division
Please print 3 copies F v v v V . 0.7-q ;
Associated Building Permit # F. Fire Sprinkler ❑i Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1715 POPRT SHEFFIELD PL
# Units
Tenant Name PALAZZOLA RESIDENCE
2. Description of Work
FIRE SPRINKLERS
Use
48HEADS
Valuation $ 4800
Extg Sq Ft New/Added Sq Ft �— Total Sq Ft �'
# Stories
FX! New ❑ Add ❑ Alter ❑ Demo
- �
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
City State F777Zip F— Telephone—
9 �I Lic. No.
❑ 4. ArchitectlDesi ner s Name Last First
Architect/Designees Address Architect/Designer's E-mail Address
City State F Zip F77 Telephone
5. Engineer's Name Last - First FI Lic. No.
Engineer's Address Engineer's E-mail Address
City State F_ ZipF77777 Telephone!
X 6. Contractor's Name Last CASEY First MONTY Lic No. 876004 1 ClassC-16
Contractor's Address Contractor's E-mail Address
1101 KINGSTON DR FIREPROOFMC@GMAIL.COM
City LA HABRA State CA7 Zip 90631 Telephone7141176-5370
OFFICE USE ONLY X�f1l�• Q�UL PERMIT NO. M
TYPE OF CONSTRUCTION PLAN CHECK NO. 04101. r+
OCCUPANCY - GROUP 14'1 ✓'2 14k(WPLAN CHECK FEE $
I
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