HomeMy WebLinkAboutF2021-0498 - Permit Application (2)x?C1Form ';
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
zc1QjFX, Fire Sprinkler C Fire Alarm r, Fire Misc
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1. Project Address (Not mailing address)
Floor
Suite No
1807 SANTIAGO DR
r—
State Zip F, Telephone—,
-
Tenant Name SANTIAGO REMODEL
# Units
Architect/Designees Address
2. Description of Work
City
------------
State F_77 zip Telephone';
F � -
3
FIRE SPRINKLERSUses
Engineer's Address
Engineer's E-mail Address
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29 HEADS
[ 6. Contractor's Name Last CASEY First FNTY J Lic. No. 876004 J Class F7
Contractor's Address
Contractor's E-mail Address
Extg Sq Ft New/Added Sq Ft Total Sq Ft
-
FIREPROFMC@GMAI L.COM
Valuation $
2900
--- '
OFFICE USE ONLY
PERMIT NO. N v s
# Stories 2
'
New [7 Add (—i Alter r Demo
OCCUPANCY - GROUP
D LJej 7 PLAN CHECK FEE $
Check Appropriate Box for Applicant/Notification
Infnrmntinn
rj 3.Owner's Name Last
First
Owner's Address
Owner's E-mail Address
- - -
city
State Zip F, Telephone—,
-
4. Architect/Designer's Name Last
FirstF77777 Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
I
City
------------
State F_77 zip Telephone';
F � -
5. En meer's Name Last
(-g
First
— _ �i Lic. No.
Engineer's Address
Engineer's E-mail Address
City
StateZip TelephonedI
[ 6. Contractor's Name Last CASEY First FNTY J Lic. No. 876004 J Class F7
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROFMC@GMAI L.COM
City LAHABRA
State CA - Zip 90631 - Telephone 711476-537 0
OFFICE USE ONLY
PERMIT NO. N v s
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
D LJej 7 PLAN CHECK FEE $