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HomeMy WebLinkAboutF2022-0076 - Permit Application (4)Print Form Worksheet for Fire Permit Application City of Newport Beach - Building Division ,,� Please print 3 copies S �<F00.YP Associated Building Permit # r Fire S rinkler p F_ Fire Alarm Fx Fire Misc 1. Project Address (Not mailing address) Floor Suite No 2888 Bayshore Dr., Newport Beach, CA 92663 � �� Tenant Name # Units ( 2. Description of Work Design a 4"PVC CL 200 underground private fire service in accordance with 2019 NFPA 24. Use Commercial Extg Sq Ft F_ New/Added Sq Ft F— Total Sq Ft F— Valuation $ 1,200.00 FX_ New r Add r Alter r Demo # Stories Check Appropriate Box for Applicant/Notification (x 3. Owner's Name Last Goetz First Andrew Owner's Address Owner's E-mail Address 2855 E. Coast Highway, Ste. 234 City Corona Del Mar State CA Zip 92625 Telephone (949) 637-8221 F_ 4. Architect/Designer's Name Last Architect/Designer's Address City First Lic. No. Architect/Designer's E-mail Address State �— Zip F TelephoneF— ix 5. Engineer's Name Last IVu First Anthony Lic. No. 1038755 Engineer's Address Engineer's E-mail Address 9559 Nightingale Ave ifire rotectiondesi ig n@gmaii.com g @gmail.com City Fountain Valley State CA Zip 92708 Telephone (714) 234-9633 fx 6. Contractor's Name Last Nguyen First Vincent Lic. No. 0084661 Class C16 Contractor's Address Contractors E-mail Address 9182 Alwick Circle xfire rotection rou P g p@gmail.com City Garden,Grove State CA Zip 92841 Telephone (714) 231-5108 OFFICE USE ONLY TYPE OF CONSTRUCTION OCCUPANCY- GROUP PERMIT NO. �i,/L3.� 0070 PLAN CHECK NO. All 1,024"" ZOZL PLAN CHECK FEE $