HomeMy WebLinkAboutF2023-0056 - 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)
19 BAY ISLAND
Tenant Name ITAMI HANNA RESIDENCE
2. Description of Work
FIRE SPRINKLERS
31 HEADS
ix Fire Sprinkler r Fire Alarm r Fire Misc
Extg Sq Ft F— New/Added Sq Ft F—Total Sq Ft
r New r Add F Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units �—
Use
Valuation$ �pQ
# Stories
F 3. Owner's Name
Last
First F—
Owner's Address
Owner's E-mail Address
City
State F—
Zip F— Telephoned
i— 4. Arch itect/Designor's
Name Last
First F— Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State i
Zip F TelephoneF
r 5. Engineer's Name
Last
First Lic. No.
Engineer's Address
Engineers E-mail Address
City
State F—
Zip F Telephoned
r 6. Contractor's Name
Last CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractors E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $