HomeMy WebLinkAboutF2021-0405 - Permit ApplicationFrittt Form
Please print 3 copies
Associated Building Permit#
1. Project Address (Not
$°i__ wpy-G
Tenant Name F—
Worksheet for Fire Permit Application Dal_
City of Newport Beach - Building Division�/ ii/ 2�21�®
Z�jZ 1_ — Z)S65 rx' Fire Sprinkler f -.. Fire Alarm r Fire Misc
ing address) Floor Suite No
t
# Units F,_
2. Description of Work tt
_ F Use U Ye _sprl� kl rs -��Y ne w SF�- (� 6 h e� d s
8 000 _
Extg Sq Ft f _-- New/Added Sq Ft � - Total Sq Ft F Valuation $ _ % -
i- New r Add r Alter
Demo
# Stories
Check Appropriate Box for Applicant/Notification
Inform -ta-
r: 3.Owner's Name Last
First r _
Owner's Address
Owner's E-mail Address
-
City
State F_M
Zip F Telephones
jx, 4. Arch itecUDesigner's Name
Last Vo
First John Lic. No.
Architect/Designees Address
526 N Shadydale Ave
Architect/Designer's E-mail Address
fireguardss@gmail.com
City West Covina
State CA
Zip 91790 Telephone 714-310-0194
- _
F_ S. Engineer's Name Last r
First r —, Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip Telephone
IXJ 6. Contractor's Name Last Fireguard Sprinkler Systems
First r—� �. Lic No. �992002 class 16
Contractor's Address
Contractor's E-mail Address
7907 Leeds Street
fireguardss@gmail.com
City Downey
State CA
Zip 90242 Telephone 714-310-0194
OFFICE USE ONLY
PERMIT NO. rC �L`�Z _D 05
TYPE OF CONSTRUCTION
PLAN CHECK NO. "
OCCUPANCY - GROUP
n 7�) (_
(s) I .�� PLAN CHECK FEE $ —