HomeMy WebLinkAboutF2022-0243 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
430 TUSTIN AVE
Tenant Name INEW RESIDENCE
2. Description of Work
FIRE SPRINKLERS
141 HEADS
Fire Sprinkler F- Fire Alarm r Fire Misc
Extg Sq Ft F New/Added Sq Ft F_ Total Sq Ft
Fx New F- Add I- Alter I- Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use I
Valuation $ 4100
i
# Stories ,2
-----------------
3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City
State Zip �— Telephoner—
( 4. Architect/Designer's Name Last First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State �— Zip F Telephoned
F_ 5. Engineer's Name
Last F- First I— Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City �
State F_ Zip F Telephoned
Fx-6. Contractor's Name
Last CASEY First MONTY Lic. No. 876004 ClasslC-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
4, PERMIT NO. (�ZdL2, dlk3
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
lit �_,t k PLAN CHECK FEE $