HomeMy WebLinkAboutF2021-0112 - Permit ApplicationWorksheet for Fire Permit Application
.Print Form p
F2021 �d ��i Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # _ ` S b FX_ Sprinkler I- Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
310 APOLENA AVE �—
Tenant Name ROSE RESIDENCE # Units F
Owner's Address
2. Description of Work
�Z3—
FIRE SPRINKLERS
Use
28 HEADS
r 4. ArchitectlDesigner's Name Last
Valuation $ 2800,
Extg Sq Ft F__New/Added Sq Ft F Total Sq Ft F__
Architect/Designees E-mail Address
# Stories F
FNew F–Add r" Alter r Demo
Check Appropriate Box for Applicant/Notification
1"fnrmnt1nn
3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
--
City State
F_
Zip F— Telephonel—
r 4. ArchitectlDesigner's Name Last
First Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City State
F—
Zip Telephone
5. Engineer's Name Last
First F77777 Lic. No. F
Engineers Address
Engineer's E-mail Address
City �— State
F
Zip F__ Telephoner
FX_: 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractors E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA State
CA
Zip 90631 Telephone 714 476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. 0(: '7 _ 10Z
OCCUPANCY -GROUP
PLAN CHECK FEE $