HomeMy WebLinkAboutF2022-0354 - Permit Application- 2U),a,_ ()3;uso
Worksheet for Fire Permit Application Print Form City of Newport Beach - Building DivisionPlease print 3 copies
Associated Building Permit # X2020-1982 DZ Fire S rinkler r- Fire Alarm p (— Fire Misc
1. Project Address (Not mailing address)
1814 Pon Charles Place
Tenant Name Custom Residence for Tim & Courtney Blackburn
2. Description of Work
New single family ire sprinkler system -50sprinklers
Extg Sq Ft �— New/Added Sq Ft 4353 Total Sq Ft 4353
Q New F_ Add F_ Alter F_ Demo
cneCK Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use lResidential
Valuation $ 5000
# Stories 12
r 3. Owner's Name Last
a_a_ `�
First F%
Owner's Address
Owners E-mail Address
City
State F—
Zip J Telephoned
j— 4. Architect/Designer's Name
Last r-_
First F_ Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_
Zip F_ Telephone—
r 5. Engineer's Name Last
First Lic No. �—
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip Telephonef ._�--- ��.--
(X6. Contractor's Name Last JB Fire Protection
First Joe Bledsoe Lic. No. 647282 Class Fc16
Contractor's Address
Contractor's E-mail Address
1229 E. Ash Ave.
joe@jbflreprotection.com
City Fullerton
State CA
Zip 92660 Telephone 714-578-0900
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $