HomeMy WebLinkAboutF2023-0434 - Permit ApplicationWorksheet for Fire Permit Application p4 �EWvpRTe
Print Form
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # r Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
125 E BAY AVE
Tenant Name IDIGIMARINO RESIDENCE
2. Description of Work
FIRE SPRINKLERS
18 HEADS
Extg Sq Ft F New/Added Sq Ft F_ Total Sq Ft
New F_ Add F Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 1800
# Stories I -
r 3.Owner's Name Last
First
Owners Address
Owner's E-mail Address
City
State F___
Zip I— Telephone—
r 4. Architect/Designer's Name Last
First Lic.
No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City F_
State F_
Zip F_ Telephonel—
F_ 5. Engineer's Name Last
First F_— Lic. No. F__
Engineer's Address
Engineer's E-mail Address
City �
State F_
Zip I Telephone-
r 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 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
•
PLAN CHECK NO.
OCCUPANCY - GROUP
(",
D PLAN CHECK FEE $
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