HomeMy WebLinkAboutF2022-0467 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach -Building Division
U41-
Please print 3 copies
Associated Building Permit #
X2022-0212 r Fire Sprinkler F— Fire Alarm
F— Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
430 El Modena
Tenant Name
# Units
F
2. Description of Work
13D - Fire Sprinkler Design (29 heads)
Use
Designer: Albert Rubio
Valuation $
7,580
Extg Sq Ft F—
New/Added Sq Ft 5125 Total Sq Ft 5125
# Stories I2
FX New F— Add
F— Alter F— Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last /,✓%/ ���
,v C_
Owner's Address
Owner's E-mail Address
City
State F__ Zip F_ Telephoned
F— 4. Architect/Designer's
Name Last First Lic. No.
Arch itect/Designer's Address
Architect/Designees E-mail Address
City
State— Zip �- Telephoned
F— 5. Engineer's Name
Last First Lic No.
Engineer's Address
Engineer's E-mail Address
City
State Zip F TelephoneF_
(X 6. Contractor's Name
Last Sanchez First Uriel Lic No. 890694
Class C-16
Contractor's Address N P r Contractor's E-mail Address
9129 Stellar Ct.
�/� 2?J uriel.sanchez@riceservicesinc.com
City Corona
State CA Zip 92883 Telephone 951-667-4220 Ed
PERMIT NO.
OFFICE USE ONLY
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TYPE OF CONSTRUCTION
PLAN CHECK N
OCCUPANCY - GROUP
PLAN CHECK FEE $
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