HomeMy WebLinkAboutF2021-0468 - Permit ApplicationWfr
Worksheet for Fire Permit Application
Print Form '
�T7U �ity of Newport Beach -Building Division
Please print 3 copies
Associated Building Permit It (X Fire Sprinkler r Fire Alarm (`•• Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1224 Devon Lane v F_ F-
Tenant Name # Units
2. Description of Work
i Fire sprinklers for remodel and addition (42 sprinklers) Use
Extg Sq Ft �— New/Added Sq Ft I Total Sq Ft `
r New r— Add r', Alter [_ Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last I First I
Owner's Address Owner's E-mail Address
Valuation $ 7,000
# Stories
City �__--__-� ,. State F--- Zip F Telephoned
FX 4. Architect/Designer's Name Last !Vo First John Lic. No. '� 4
ArchitecUDesigner's Address Architect/Designer's E-mail Address
526 N Shadydale Ave fireguardss@gmail.com
City West Covina State MCA'. Zip 91790 Telephenej714-31U-0194
r 5. Engineer's Name Last I First Lic. No. _—
rEngineers Address Engineer's E-mail Address
�_
City _.. _.. State F— Zip F Telephone!.
rX 6. Contractor's Name Last Fireguard Sprinkler Systems I First Lic No. 992002 Class 16
Contractor's Address Contractor's E-mail Address
7907 Leeds Street fireguardss@gmail.com
City Downey State MCA Zip 90242 Telephone 714-310-0194
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
VW'_0M
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $