HomeMy WebLinkAboutF2021-0264 - Permit ApplicationWorksheet for Fire Permit Application
Prlhk Form ; .' qty of Newport Beach - Building Division
2
201— Cf
Please print 3 copies <"0 '
Associated Building Permit # [ Fire Sprinkler [Fire Alarm [Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
211 TUSTIN AVE
Owner's E-mail Address
Tenant Name NEW RESIDENCE
®
# Units
2. Description of Work
First Lic. No.
Use
FIRE SPRINKLERS jAN g2o
5t HEADS
NTE–RVVEST=----'
Extg Sq Ft � New/Added Sq Ft �
CONSULTING t
Total Sq Ft I
Valuation 5 5100
- -- -
Zip 177777 Telephoned
5. Engineer's Name Last
# Stories I37
r' New [ Add [ Alter [ Demo
Engineers Address
Check Appropriate Box for Applicant/Notification
Infn�w�4inn
3. Owner's Name Last
First—!
Owner's Address
Owner's E-mail Address
City
State F_
Zip F7777 Telephoned
4. Architect/Designer's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
StateF 7
Zip 177777 Telephoned
5. Engineer's Name Last
First �I Lic. No.
Engineers Address
Engineer's E-mail Address
City
J
State
Zip F777 Telephone d
PK 6. Contractor's Name Last CASEY
First MONTY Lic. No. 876004 _j Class C-16
Contractor's Address
Contractor's 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 N
OCCUPANCY - GROUP
PLAN CHECK FE