HomeMy WebLinkAboutF2021-0477 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
Please print 3 copies °"°�° of?�"m
City of Newport Beach - Building Division �{, �
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Associated Building Permit # �— r Fire Sprinkler I— Fire Alarm r Fire Misc
1. Project Address I
221 Berkshire Lane, Newport Beach, CA 92660
Tenant Name
2. Description of Work
Design build a 1-story RESIDENTIAL fire sprinkler system as per 2019 NFPA 13D (32) heads.
Extg Sq Ft New/Added Sq Ft 4,811 Total Sq Ft 4;811
Ix New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use SFR
Valuation $ 6,100.00
# Stories F
�X 3. Owner's Name
Last Phan First Phuoc
Owner's Address
Owner's E-mail Address
3 Grass Valley
City Irvine
State CA Zip 92602 Telephone (949) 683-0220
r 4. Architect/Designer's Name Last First I— Lic. No.
F m--
Architect/Designer's Address
Architect/Designers E-mail Address
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City
State F___ Zip—®_®® Telephone.®—
r 5. Engineer's Name
Last Vu First Anthony Lic. No.
1038755
Engineer's Address
Engineer's E-mail Address
9559 Nightingale Ave
ifireprotectiondesign@gmaii.com
City Fountain Valley
State CA Zip 92708 Telephone (714) 234-9633
r 6. Contractor's Name
Last Vu First Fthony Lic. No. 1038755 Class C16
Contractor's Address
Contractor's E-mail Address
9559 Nightingale Ave
ifireprotectiondesign@gmail.com
City Fountain Valley
State CA Zip 92708 Telephone (714) 234-9633
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
�� �� PLAN CHECK NO`el
PLAN CHECK FEE $
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