HomeMy WebLinkAboutF2022-0285 - Permit ApplicationWorksheet for Fire Permit Application o j
Print Form
City of Newport Beach - Building Division ?`
Please print 3 copies
Associated Building Permit #
Fire Sprinkler r Fire Alarm r Fire Misc:
N
1. Project Address (Not mailing address) Floor Suite No
3702 PARK LANE
Tenant Name NIJJAR RESIDENCE # Units
2. Description of Work
_
FIRE SPRINKLERS
Use
27 HEADS
Valuation $ 2700
Extg Sq Ft � New/Added Sq Ft F Total Sq Ft
# Stories I3
New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Inf^rm�+inn
F 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City �
State F—
Zip F Telephoned
1 4. Architect/Designer's Name Last
First F Lic. No. �—
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City
State F_
Zip F_ Telephoned
F_ 5. Engineer's Name Last f
First F_ Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F Telephoned
X 6. Contractor's Name Last CASEY
First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip 9F0631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. ZoZZ - OZ %S
14yq-2a22
TYPE OF CONSTRUCTION —
Qy 7q PLAN CHECK NO.
OCCUPANCY - GROUP
0201
7,-9 PLAN CHECK FEE $
X 10211- 1 S 5�