HomeMy WebLinkAboutF2021-0224 - Permit ApplicationWorksheet for Fire Permit Application aV-W��0-2'
Print Form p �n I u7,7,y City of Newport Beach - Building Division 3
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Please print 3 copies
Associated Building Permit # (X Fire Sprinkler r Fire Alarm (— Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
1375 Dove St
3rd
300
Tenant Name / �i(Yr Z
/
#Units �-
2. Description of Work
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_
Fire Sprinkler Tl -19 sprinklers
Use ice
First I Lic. No. r
Engineer's Address
Valuation $
1850
EMg Sq Ft F_New/Added Sq Ft � Total Sq Ft �—
F 6. Contractor's Name Last Fire Protection Specialists, Inc First FRobert Anderson Lic. No. 464915 class c-16
Contractor's Address
Contractor's E-mail Address
2810 E. Miraloma Ave
robert@fireprotectionspecialists.com
City Anaheim
# Stories3
F- New r Add rX Alter r" Demo
VG®L, , 04, PERMIT NO,
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Check Appropriate Box for Applicant/Notification
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F 3. Owner's Name Last
� FirstI
Owner's Address
Owner's E-mail Address
City I
State F_ Zip F— Telephone—
r 4. ArchitectIDesigner's Name
Last First F_ Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State r Zip F TelephoneF
r— 5. Engineer's Name Last
First I Lic. No. r
Engineer's Address
Engineer's E-mail Address
City �
State F Zip F— Telephoned
F 6. Contractor's Name Last Fire Protection Specialists, Inc First FRobert Anderson Lic. No. 464915 class c-16
Contractor's Address
Contractor's E-mail Address
2810 E. Miraloma Ave
robert@fireprotectionspecialists.com
City Anaheim
State CA Zip 92806 Telephone 714-635-6500
OFFICE USE ONLY
VG®L, , 04, PERMIT NO,
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
`.� PLAN CHECK NO.
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PLAN CHECK FEE $