HomeMy WebLinkAboutF2020-0310 - 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)
210 GOLDENROD AVE
Tenant Name NEW RESIDENCE
2. Description of Work.
FIRE SPRINKLERS
47 HEADS
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X Fire Sprinkler F_ Fire Alarm r- Fire Misc
Extg Sq Ft F— New/Added Sq Ft F— Total Sq Ft
jX New r Add F_ Alter i— Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F—
Use
Valuation $ 4700
# Stories
r 3. Owner's Name Last
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wU
First RT
Owner's Address
Owner's E-mail Address
City
State
Zip [ Telephoned
F 4. Arch itect/Desig nor's Name
Last
FirstF Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State �—
Zip F_ Telephone—
r 5. Engineer's Name Last
First F Lic. No. I v
Engineer's Address
Engineers E-mail Address
City
State �—
Zip F—.— TelephoneF_
IX 6. Contractor's Name Last CASEY
First FMONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA
Zip 90631 Telephone 1 7144-476-537�10
OFFICE USE ONLY
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X PERMIT NO. VD W D 31
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TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
J�'• PLAN CHECK Nn • ��
l� w PLAN CHECK FEE
$