HomeMy WebLinkAboutF2020-0379 - Permit ApplicationPrint Form„”
Worksheet for Fire Permit Application U01�010214111,City of Newport Beach -Building Division,nPlease print 3 copies F „�] ` ,
Associated Building Permit # [I Fire Sprinkler F_ Fire Alarm F_', Fire Misc
ss (Not mailing address) Floor Suite NO
Last - - �yLtl,Ue✓ - JI First
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12 BURNINGTREE
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Tenant Name BURGENER RESIDENCE # Units F77
City
- -
2. Description of Work
Use
FIRE SPRINKLERS
66 HEADS
Architect/Designer's E-mail Address
i
City
Valuation $ 6600
Extg Sq Ft New/Added Sq Ft F Total Sq Ft F '
- - - I
neer's Name
5. Engineer's
#Stories
Ixi New FI Add h Alter r Demo
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Check Appropriate Box for Applicant/Notification
F. 3. Owner's Name
Last - - �yLtl,Ue✓ - JI First
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Owner's Address
Owner's E-mail Address
City
- -
State Zip �' Telephoned
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r 4. Arch itectiDesigner's
Name Last - - First Lic. Z777
Architect/Designees Address
Architect/Designer's E-mail Address
i
City
StateZip TelephoneI-
-
- - - I
neer's Name
5. Engineer's
Last First
I --- I Lic. No.
Engineer's Address
Engineer's E-mail Address
City1
StateF777Zip F Telephone
[j 6. Contractor's Name
Last CASEY First MONTY Lic. No.876004 Class C7
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
StateCA Zip 90631 Telephone 714 476-5370
OFFICE USE ONLY
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rj�,DI D PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
�J 3� p , I PLAN CHECK FEE $