HomeMy WebLinkAboutF2021-0278 - Permit Applicationa,
Worksheet for Fire Permit Application
Print Form
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # 3? Fire Sprinkler F F- rrrr Fire Misc
1. Project Address (Not mailing address) Floor Suite No
29 Zurich Circle, Newport Beach, CA 92663 F F_
Tenant Name kurich Circle Trust Residence
2. Description of Work
new residential fire sprinkler system with 98 heads
Edg Sq Ft F_ New/Added Scl Ft r�- Total Scl Ft 7138
X New F Add F_ Aker F Demo
Check Appropriate Box for Applicant/Notification
# Units F
Use
Valuation $ 15500�
# Stories
F 3. Owners Name Last
First [_
Owners Address
Owner's E-mail Address
City
(-
State Zip I Telephoned—
r 4. Architect/Designer's Name
Last Mitchell First rent Lic. No. �-
Architect/Designers Address
Architect/Designers E-mail Address
City I
State r-- Zip �— Telephoned_--
r 5. Engineer's Name Last r--
First F Lic. No.
Engineers Address
Engineer's E-mail Address
City I—
State r- Zip r— Telephoner—
Q 6. Contractor's Name Last Dougherty Forst Folt Lic No. FI5588 Class -16
Contractors Address
Contractors E-mail Address
2672 Lambert Street #619
ott.allstar@gmail.com
City Lake Forest
State Ca -- Zip F2630 Telephonebol-64r 7-6161 -
OFFICE USE ONLY
��,�+ ") PERMIT NO. -�
TYPE OF CONSTRUCTION
r� f �{ r • , r ����✓ PLAN CHECK NO.
OCCUPANCY - GROUP
l"�` �`� G PLAN CHECK FEE $