HomeMy WebLinkAboutF2021-0266 - Permit Application— VVorksheet for Eire Permit Application ��"r
Print Form pp on 6
L -•- — City of Newport Beach - Building Division �
Please print 3 copies "oa„.�
Associated Building Permit # X2019-4077. IK• Fire Sprinkler r; Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
12309 Santiago Drive
Tenant Name
2. Description of Work
Fire sprinklers for new main house (49 sprinklers)
Extg Sq Ft �_--� New/Added Sq Ft F—_- .--�..; Total Sq Ft F _...
j— New Add I`. Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation $ 8,000
# Stories F
F 3. Owner's Name Last
'��
1�
First
Owner's Address
Owner's E-mail Address
city
! State F_.
Zip I--- Telephone—
fx 4. Architect/Designer's Name
Last vo
First John Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
City West Covina
State CA
Zip 91790 Telephone 714-310-0194
1 5. Engineer's Name Last
First_-.- , Lic. No.l
Engineer's Address
E-mail Address
rrEngineer's
City I _._ _
State �--
Zip r Telephone
(X 6. Contractor's Name Last Fireguard Sprinkler Systems
First �— Lic No. 992002 Class 16
Contractor's Address
7907 Leeds Street
Contractor's E-mail Address
Ifireguardss@gmail.com
City (Downey
State CA
Zip 19024� 2 Telephone 714-310 0194
OFFICE USE ONLY
qf4 FT. b PERMIT NO. T W Z Y 172,16 fi
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TYPE OF CONSTRUCTION
PLAN CHECK NO E I ' �21
OCCUPANCY -GROUP
x_ . (el PLAN CHECK FEE $