HomeMy WebLinkAboutF2021-0035 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
FX Fire Sprinkler F- Fire Alarm F- Fire Misc
1. Project Address (Not mailing address)
1706 MARIGOLD AVE
Tenant Name INOUYE RESIDENCE
2. Description of Work
FIRE SPRINKLERS - 35 HEADS
Extg Sq Ft F New/Added Sq Ft F
Fx New F— Add F— Alter F— Demo
Check Appropriate Box for ApplicanUNotification
Total Sq Ft F_
Floor Suite No
v Ai' # Units F—
Y�
Valuation $ 3500
# Stories
F 3. Owner's Name Last--
First r—
Owners Address
Owner's E-mail Address
City I
State F Zip F_ Telephoned-
r 4. Architect/Designer's Name
Last First I— Lic. No.
F—
Architect/Designers Address
Architect/Designees E-mail Address
City �
State �— Zip Telephone
r 5. Engineer's Name Last
�— First F_ Lic. No.
�—�—
Engineers Address
Engineer's E-mail Address
City
State Zip TelephoneF --
r 6. Contractor's Name Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractors 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
V ZbcI / PERMIT NO.
TYPE OF CONSTRUCTION
i
`' '-`-(J��
OCCUPANCY - GROUP
� ��,,�
lJ ' C PLAN CHECK FEPLANCHECKNE $