HomeMy WebLinkAboutF2023-0136 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
522 Via Lido Nord, Newport Beach
Tenant Name # Units F
2. Description of Work
Design and Installation of Fire Sprinkler System per NFPA 73D
Use
-
Valuation $ 6,350
r
Extg Sq Ft I New/Added Sq Ft f Total Sq Ft 1,664
#Stories F
r New (" Add r Alter r Demo `1Z t'leOe�S)
Check Appropriate Box for Applicant/Notification
I nfnrm Minn
F_ 3. Owner's Name Last
FirstF_
Owner's Address
Owner's E-mail Address
City �
State I
Zip F_ Telephoned'
)X 4. Arch itect/Designer's Name Last
Gutierrez First Rubi Lic. No.�
Architect/Designer's Address
Architect/Designer's E-mail Address
8085 E. Crystal Dr.
RubiG@resfire.com
City Anaheim
State CA
Zip 92807 Telephone (714)666-8450
(— 5. Engineer's Name Last—
First, Lic.No.�
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip F_ Telephone
r 6. Contractor's Name Last Residential Fire Systems
First F — Lic. No. 786965 Class F16
Contractor's Address
Contractor's E-mail Address
8085 E. Crystal Dr.
engineering@resfire.com
City Anaheim
State CA
Zip 92807 Telephone (714)666-8450
OFF/CEUSE ONLY
PERMIT NO.
�I '
TYPE OF CONSTRUCTION
W
\
PLAN CHECK NO.
OCCUPANCY- GROUP
1
"
p PLAN CHECK FEE $