HomeMy WebLinkAboutF2022-0157 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
508 VIA LIDO NORD
F_
F_
DEVIR RESIDENCE
# Units
F
Tenant Name
2. Description of Work
FIRE SPRINKLERS
Use
32 HEADS
Valuation $ 3200
Extg Sq Ft F—New/Added Sq Ft � Total Sq Ft
# Stories
I2
iX New F Add F Alter r Demo
Check Appropriate Box for Applicant/Notification
Informtoon
r— 3. Owner's Name Last
First [_
Owner's Address
Owner's E-mail Address
City F_ State
F— Zip Telephoned
F 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City State
F_ Zip F Telephoned
5. Engineer's Name Last
First Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City State
F_ Zip F_ TelephoneF
IX 6. Contractor's Name Last CASEY
First IMONTY 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 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. ZOZ2
NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
J� /I b PLAN CHECK
/ 1 !/(ri
CHECK FEE
PLAN $
`_Q 20Z1 BD4z�?1