HomeMy WebLinkAboutF2021-0350 - Permit ApplicationWorksheet for Fire Permitplication
f ityYnit.`' a City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# Fire Sprinkler F- Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
514Acacia Ave --
Tenant Name
2. Description of Work
Fire sprinklers for MFR (52 heads)
Extg Sq Ft r New/Added Sq Ft F Total Sq Ft F
F New ( Add F. Alter F_ Demo
Check Appropriate Box for ApplicanVNotification
Floor Suite No
3 3
#Units I
i
Use I_._._...........
Valuation $ 7,500
# Stories f 3
F 3. Owner's Name
Last �� , , First F i
Owner's Address
Owner's E-mail Address
City
State 3— Zip ___ W6 Telephone
jx 4. Arch itect/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 CA Zip 91790 Telephone 7143100194
F_ 5. Engineer's Name
Last First — Lic No.r
Engineer's Address
Engineer's E-mail Address
City �
State F-- Zip I TelephoneF—
FX- 6. Contractor's Name
Last Fireguard Sprinkler Systems First F Lic. No. 992002 Class F6
Contractor's Address
Contractor's E-mail Address
7907 Leeds Street
fireguardss@gmail.com
City Downey State CA Zip 90242 Telephone 7143100194
OFFICE USE ONLY
V/I r{i p q PERMIT NO. �p�'� • 0350
J V V
TYPE OF CONSTRUCTION —_ PLAN CHECK NO. o �'
II OCCUPANCY -GROUP
IL
/VJ,I n PLAN CHECK FEE $