HomeMy WebLinkAboutF2022-0252 - Permit ApplicationWorksheet for Fire Permit Application ozOFN
City of Newport Beach - Building Division o
Please print 3 copies �°"
Associated Building Permit # Fx- Fire Sprinkler �, Fire Alarm rFire Misc
1. Project Address (Not mailing address)
127 G Street _
Tenant Name
2. Description of Work
Fire Sprinklers for new SFR (27 sprinklers)
Extg Sq Ft F_, New/Added Sq Ft �-.-.-----. Total Sq Ft F_..
F- New [i'••'' Add F_ Alter (•;! Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units F
Use
Valuation $ 6,000
# Stories �.
I-', 3.Owner's Name Last F—
_. First
Address
Owner's E-mail Address
(Owner's
..City
_
... _...
State F—_
Zip F---.-._....._. Telephoned....--_.-._—_...._'..
r 4. Architect/Designer's Name
Last Vo
First FJohn Lic No. F-- -
Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmaiLcom
City West Covina
State CA
Zip 91790 Telephone 714-310-0194
F-', S. Engineer's Name Last
��.
First F_, Lic. No. F_
Engineers Address
Engineer's E-mail Address
City �.._.. _._
State �
Zip ..___ Telephone[—
r, 6. Contractor's Name Last Fireguard Sprinkler Systems First Lic No. 992002
Class 16
Contractor's Address
Contractors E-mail Address
7907 Leeds Street
fireguardss@gmaiLcom
City Downey
State CA
Zip 90242 Telephone 714-310-0194
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OFFICE USE ONLY •
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PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
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OCCUPANCY- GROUP
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PLAN CHECK FEE $
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