HomeMy WebLinkAboutF2019-0448 - 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)
304 POPPY AVE
Tenant Name POPPY RESIDENCE
2. Description of Work
FIRE SPRINKLERS
53 HEADS
JX— Fire Sprinkler r Fire Alarm r Fire Mis�
Extg Sq Ft F— New/Added Sq Ft F— Total Sq Ft
r New i— Add i Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 5,300.00
# Stories I
r.
F- 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City F
State F—
Zip F Telephoned
r 4. ArchitectlDesigner's Name
Last
�---
First F— Lic. No. li
Architect/Designees Address
Architect/Designer's E-mail Address
City
State
Zip F Telephone
r 5. Engineer's Name Last
First F— Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip r Telephoned
F 6. Contractor's Name Last CASEY
First FMONW 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 714-476-5370
OFFICE USE ONLY
G3
n
�� PERMIT NO. 'I,ae l9'i . E>4--i D
TYPE OF CONSTRUCTION
PLAN CHECK NO. tIS1-I& 51
OCCUPANCY - GROUP
✓ PLAN CHECK FEE $