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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division ve �\ - plp1J6
(X Fire Sprinkler r- Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
i908 W.00EANFRONT ( F_
RESIDENCE # Units F --
Tenant Name IHARVEY
2. Description of Work
FIRE SPRINKLERS
Use
56 HEADS
Valuation $ 4700
Extg Sq Ft 7 New/Added Sq Ft F_Total Sq Ft
r—
# Stories 13
); New F_ Add F_ Alter F_ Demo
Check Appropriate Box for Applicant/Notification
I- 3. Owner's Name
Last I G{ Vj ►la. QN Ul-- First F
1 ITV
Owner's Address
O ners E-mail Address
3l11 2 ?1
City
State Zip Telephone
F_ 4. Architect/Designees
Name Last First — Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State F_ Zip F— Telephoned
f 5. Engineer's Name
Last First Lic. No. �
Engineer's Address
Engineer's E-mail Address
City
State F Zip F_ Telephoned
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 Telephone1714-47� 6-5370
OFFICE USE ONLY
PERMIT NO. L02I . 000(o
2�� ti47 l
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
(ln/ PLAN CHECK FEE $