HomeMy WebLinkAboutF2023-0446 - Permit ApplicationP nt Form
Please print 3 copies
Associated Building Permit #
r._
1. Project Address (Not
r29TillerWay
_ienant Name
2. Description of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
address)
i Fire sprinklers for new SFR (42 heads)
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0
Fire Sprinkler r Fire Alarm (— Fire Misc
Extg Sq Ft NewlAdded Sq Ft i Total Sq Ft
F New F Add F Alter — Demo
%..net;K mppropriaxe MOX Tor AppiiCaTiVINIotiSlcation
i"" 3. Owners Name Last
Cwner's Address
_.._. First I.__..._..-_.�............_
Owner's E-mail Address
Floor Suite No
# Units
Use
Valuation $ 9,Ooo
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Fi p
i
# Stories
• i , StateZip (� Telephoned_ j
iX 4. Arch ite_-UDesigner's Name Last Vo First John __ Lic. No.
i
I Arch itect/Designer's Address Architect/Designer's E-mail Address
.526 N d Shadyale Ave ruardss i Ifire g @gmail.com �
City West Covina State CA Zip 191790 Telephone+714-310-0194
f F_ Engineer's Name Last First ;
€ ;
I
Engineer's Address wv_ Engineer's E-mail Address Lic No.
City F State F Zip F Telephone�� g
X 6. Contractor's Name Last Fireguard Sprinkler Systemsu First Lic No. 942002 Class 16 j
Contractor's Address Contractor's E-mail Address
17907 Leeds Street fireguardss@gmail.com +
city Downey State [CA Zip 90242 Telephone 714-310-0194
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OFFICE USE ONLY PERMIT NO. r2'7.27`t'�b
TYPE OF CONSTRUCTION y� PLAN CHECK'•d0.2Q23
OCCUPANCY - GROUP '�-a'3/2-
> PLAN CHECK FEE $ —
2 .17ita