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HomeMy WebLinkAboutF2021-0280 - Permit ApplicationPrint Form Worksheet for Fire Permit Application City of Newport Beach - Building Division Please print 3 copies I 021-1 9 If. 1) G<,FoaN' Associated Building Permit # )(Z,c) Zo - t U E � r Fire Sprinkler (- Fire Alarm r Fire Misc 1. Project Address (Not mailing address) Floor Suite No 125 26th F_ Street_ __ ` S Fs Telephone Tenant Name # Units r� Serra.._ Architect/Designer's E-mail Address 2. Description of Work State Zip F TelephoneF— Install automatic fire sprinkler system in new single family Use Residence residence. R 3 I U City State I— Valuation $ 8, 000.00 Extg Sq Ft � New/Added Sq Ft �—' Total Sq Ft 2985 Contractor's E-mail Address 520 Texas St. # Stories I�3"'� jK New r Add r Alter Demo City Redlands e , <' ? 12— Zip 92374 Telephone 909-793-0676 OFF/CE USE ONLY Check Appropriate Box for Applicant/Notification 3. Owner's Name Last First Owner's Address Owner's E-mail Address City StateZip Fs Telephone 4. ArchitecVDesigner's Name Last First �— Lic No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip F TelephoneF— rS. Engineer's Name Last First F_ Lic. No. Engineer's Address Engineer's E-mail Address City State I— Zip Telephone FX_ 6. Contractor's Name Last Summit Fire Protection First F Lic. No.362801 Class c-16 Contractor's Address Contractor's E-mail Address 520 Texas St. mail@summitfirepros.com City Redlands e State CA _ Zip 92374 Telephone 909-793-0676 OFF/CE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO. 1"L5 - %sVZ t OCCUPANCY -GROUP �� ,�� 6� PIAN CHECK FEE $