HomeMy WebLinkAboutF2023-0333 - Permit ApplicationPrint 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)
1405 Priscilla Lane
Tenant Name
2. Description of Work
Design/Install new NFPA 13D Fire Sprinkler System
Extg Sq Ft F_ New/Added Sq Ft F
IX New r Add F_ Alter r Demo
r Fire Sprinkler [_ Fire Alarm F_ Fire Misc
11i1 4i6*
Check Appropriate Box for Applicant/Notif!cation
Total Sq Ft 3928
Floor NjeN#Units
Use
Valuation $ 1 iljg'i
# Stories F
F 3. Owner's Name Last
First F—
Owner's Address
Owner's E-mail Address
City
State F__ Zip F_ Telephoner
r— 4. Architect/Designer's Name
Last First Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State F__ Zip F— Telephoned
(— 5. Engineer's Name Last
�— First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State 7— Zip F TelephoneF_
r 6. Contractor's Name Last
First F— 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 F5l-667-4220
OFFICE USE ONLY
PERMIT NO. "I /
TYPE OF CONSTRUCTION
���� PLAN CHECK NO. 16ZO — ?_—
OCCUPANCY - GROUP
4 and ,p�l� PLAN CHECK FEE $