HomeMy WebLinkAboutF2021-0120 - Permit Applicationr Worksheet for Fire Permit Application
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City of Newport Beach -Building Division
Please print 3 copies
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1. Project Address (Not mailing address) Floor Suite No
3 Rocky Point Road.... F
Tenant Name # Units
2. Description of Work III
Fire sprinklers for new SFR (86 sprinklers) Use m U
Valuation $ 13,000
Extg Sq Ft New/Added Sq Ft Total Sq Ft
# Stories
r New F— Add f— Alter F_ Demo
Check Appropriate Box for Applicant/Notification
3.Owner's Name Last �
First
Owner's Address
Owner's E-mail Address
City State
F
Zip �— Telephoned
F�_< 4. Architect/Designer's Name Last Vo
First John Lic. No. I +
Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
City West Covina State
CA
Zip 91790 Telephone 7143100194
F` 5. Engineer's Name Last
'First— Lic No. F_
Engineers Address
Engineers E-mail Address
City State
�—
Zip Telephoned
[X, 6. Contractor's Name Last Fireguard Sprinkler
-: First F Lic No..992002 Class 16.._....
Contractor's Address
Contractors E-mail Address
7907 Leeds Street
fireguardss@gmail.com
City Downey State
CA
Zip 90242 Telephone 7143100194
OFFICE USE ONLY
PERMIT NO. o 114D
TYPE OF CONSTRUCTION —_
PLAN CHECK NO. 0_7l! 1 ^ 227u
OCCUPANCY -GROUP
_ OZ C LI PLAN CHECK FEE $