HomeMy WebLinkAboutF2021-0401 - Permit ApplicationWorksheet for Fire Permit Application
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City of Newport Beach -Building Divisionppal�A
Please print 3 copies % 5 _ �LO�
Associated Building Permit # xW`� V7() l r Fire Sprinkler F-,1 Fire Alarm n Fire Misc
1. Project Address (Not mailing address) Floor Suite No
FRO _4x ord __Lave
Tenant Name # Units
2 Description of Work
rive spr^i4kleYs 4r (emodel akidcddlhj pl .(�4 -hol) Use
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Valuation $ 6/ O00
Extg Sq f —
F_! New/Added Sq Ft F���� Total Sq Ft
# Stories Tr-,
New r Add r',, Alter r!, Demo
Check Appropriate Box for Applicant/Notification
Information
F-1 3. Owner's Name Last I l7Y Firs - C, ii,
Owner's Address
Owner's E-mail Address
City _ y State r`—;
Zip F—_.I Telephone—,
X, 4. ArchitecVDesigner's Name LastVo
First John Lic. No.
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Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
city West Covina StateCA
Zip 91790 Telephone 714-310 0194
5. Engineer's Name Last F� __. __..
First F—.. .7 Lic. No.
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Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone
r; 6. Contractor's Name Last Fireguard Sprinkler Systems..
First Lic No.992002 Class 16.__.
Contractor's Address
Contractor's E-mail Address
_ _
7907 Leeds Street
ifireguardss@gmail.com
City Downey I StateFA
Zip 190242� Telephone 714-310-0194
OFFICE USE ONLY
PERMIT NO.�
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $
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