HomeMy WebLinkAboutF2022-0304 - Permit ApplicationPruit Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
217 Larkspur Ave
Tenant Name 1
2. Description of Work
Fire sprinklers for new SFR (43 heads)
[X Fire Sprinkler r' Fire Alarm r Fire Misc
Extg Sci Ft ( ---- New/Added Scl Ft ---__---- Total Scl Ft
�. New i - Add r Alter F_ Demo
ve ICU �NNr UNnate rSUX Tor Applicant/Notification
I^for.[Tlatio^
Floor Suite No
# Units
Use
Valuation
Valuation $ 9p00
# Stories 3
3. Owner's Name Last F First
Owner's Address E-mail Address
(Owners
City State �..� Zip r— Telephoned..--_-___._.__..
jxx 4. Architect/Designer's Name Last Vo First John Lic. No.
_
Architect/Designer's Address Architect/Designer's E-mail Address
526 N Shadydale Ave fireguardss@gmail.com
City West Covina state F A Zip 91790 Telephone 714-310-1094
r 5. Engineer's Name Last F—First F_—._� Lic, No. F��
Engineer's Address Engineers E-mail Address
City State �_- ZipI�— Telephone
r16. Contractor's Name Last Fireguard Sprinkler Systems First u Lic No. 992002 Class 16
Contractor's Address Contractor's E-mail Address
7907 Leeds Street fireguardss@gmail.com
City Downey State CA Zip 19024� 2 -` Telephone l714- 013 0194
OFFICE USE ONLY PERMIT NO. FZ4ZZ - 0304
TYPE OF CONSTRUCTION — PLAN CHECK NO. I_533- Zo2Z
OCCUPANCY - GROUP t17dZ®� AtiZL PI AN CHFrK FFF It
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