HomeMy WebLinkAboutF2022-0642 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # X2022-1242 r Fire Sprinkler r— Fire Alarm rFire Misc
1. Project Address (Not mailing address)
213 Via Ithaca, Newport Beach, Ca 92663
Tenant Name
2. Description of Work
NFPA 13D Fire Sprinkler Design (38 Heads)
Designer: Gus Lopez
Extg Sq Ft New/Added Sq Ft 2955 Total Sq Ft 2955
r New F- Add F_ Alter F_ Demo
Check Appropriate Box for Applicant/Notification
I-F_ _t;
Floor Suite No
# Units I 1
Use
Valuation $ 5,515
# Stories
(— 3. Owner's Name Last
Firstl—_
Owners Address
Owner's E-mail Address
City
State F
Zip F_ Telephoned
(" 4. Architect/Designer's Name
Last
First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State r
Zip F_ Telephoned.
F_ 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F— Telephoned
(K 6. Contractor's Name Last Mahood First Kelly Lic. No. 890694 Class C-16
Contractor's Address
Contractor's E-mail Address
9129 Stellar Ct.
NPFire@riceservicesinc.com
City Corona
State CA
Zip 92883 Telephone 951-667-4220 ed
OFFICE USE ONLY
PERMIT NO. FtzvJ, �7 N
TYPE OF CONSTRUCTION
Z - 3 1257
PLAN CHECK NO. f t: �L
OCCUPANCY - GROUP
LcrZ/ fi —
o.7r2 � PLAN CHECK FEE $