HomeMy WebLinkAboutF2021-0039 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1218 Goldenrod
Tenant Name Don Briscoe
2. Description of Work
Design and install a fire sprinkler system for new residence
rX Fire Sprinkler r Fire Alarm r Fire Misc
Extg Sq Ft F— New/Added Sq Ft F_— Total Sq Ft 6853
�C New f Add F Alter F Demo
I WWA ivr nppucdn1Jr100r1cavon
Floor Suite No
# Units F—
Use residential
Valuation $ 2o,0oo.00
# Stories I_
f 3. Owner's Name Last
First F--
Owners Address
Owner's E-mail Address
City
State �—
ZIP Telephoner—
F 4. Arch itectIDesigner's Name
Last r % First �je41�— Lic. No. I—
Architect/Designers Address
=I I ArchitectiDesigners E-maiLpddress
City
State I �� Zip [_ Telephone` --
I— 5. Engineer's Name L®
First F— F
Lic. No.
®�
Engineers Address
Engineers E-mail Address
Cih'
State �— Zip F_ Telephone—
r 6. Contractor's Name Last Parise First Ryan Lic. No. 787301 Class C16
Contractors Address
Contractors E-mail Address
1261 N. Lakeview Ave. #J515
stacey@valonfire.com
City Anaheim
State CA Zip 92807 Telephone 714-238-9285
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $i