HomeMy WebLinkAboutF2021-0279 - Permit ApplicationWorksheet for Fire Permit Application
Please print 3 copies un
Print Form City of Newport Beach -Building Division
Associated Building Permit #
D? Fire Sprinkler F— Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
1424 Santanella Terrace, Corona Del Mar, CA 92625
F_
Tenant Name Residence
# Units
eller
2. Description of Work
nstall new residential fire sprinkler system with 36 heads
Use
E#g Sq Ft I— New/Added Sq Ft 9 Total Sq Ft V645
Valuation $
6500
# Stories
0—
5? New f— Add i— Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Inforguntion
r 3.Owner's Name
Last �—- FirstF_
Owner's Address
Owner's E-mail Address
City
State ^._ Tip F TelephoneF_
b 4. ArchitectlDesigner's Name Last Imitchell First rent Lic. No.
F
ArchitecLIDesigners Address
Architect/Designers E-mail Address
City
State F_ Zip f TelephoneF_
f— 5. Engineer's Name
Last � FirstF_Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F Zip F_ Telephoned
R 6. Contractor's Name
Last ougherty First Folt Lic No. F15588 Class -16
Contractors Address
Contractors E-mail Address
672 Lambert Street #619
oltallstar@gmail.com
City kke Forest
State T ° Zip 2630 Telephone 01-647-6161
OFFICE USE ONLY
-Wd << o�3� PERMIT NO. Tq
TYPE OF CONSTRUCTION o PLAN CHECK NO.
OCCUPANCY - GROUP
S 2- (/� PLAN CHECK FEE $