HomeMy WebLinkAboutF2021-0302 - Permit Applicationr'rint Form
Please print 3 copies
Associated Building Permit #
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Worksheet for Fire Permit Application p� e�
City of Newport Beach - Building DiviF
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(x Fire Sprinkler f— Fire Alarm r— Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
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207 Evening Canyon Road
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# Units
Tenant Name
2. Description of Work
Use
NFPA 13D Fire Sprinkler System
Valuation $ 12,365
Extg Sq Ft New/Added Sq Ft
Total Sq Ft 4,419
# Stories
(X New r— Add r Alter Demo
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Check Appropriate Box for Applicant/Notification
[— 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City
State Zip Telephone
jX 4. Architect/Designer's Name Last Gutierrez First Rubi Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
8085 E. Crystal Dr.
RubiG@resfire.com
City Anaheim
State CA Zip 92807 Telephone 1 (714)666-8450
(— 5. Engineer's Name Last FirstF Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip Telephoned
(X 6. Contractor's Name Last Residential Fire Systems First Lic. No. 786965 Class
F16
Contractor's Address
Contractor's E-mail Address
8085 E. Crystal Dr.
engineering@resfire.com
City Anaheim
State CA Zip 92807 Telephone 1 (714)666-8450
OFFICE USE ONLY
(� „�� _ G "✓� I / PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO. U
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OCCUPANCY - GROUP
PLAN CHECK FEE $
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