HomeMy WebLinkAboutF2022-0062 - Permit ApplicationWorksheet for Fire Permit Application
il#�fP City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # iX Fire Sprinkler I- Fire Alarm r Fire Misc
1: Project Address (Not mailing address)
Floor Suite No
1918 Highland Drive
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Name
# Units
Tenant
2. Description of Work
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S
Use 1{
Fire sprinklers for remodel SFR (29 heads)
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Ft Total Sq Ft
Valuation $
6,000
Extg Sq Ft
_ New/Added Sy
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r. New f-- Add f Alter I-t Demo
Check Appropriate Box for Applicant/Notification
#Stories I
r- 3. Owner's Name
Last (
v First ��—
Owner's Address
Owner's E-mail Address
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City � --
State I s---
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- lip- — Telephone. --..
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(X 4. Architect/Designer's Name Last tVo—
First Jahn Lic. No. F.�-
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
f26 N Shadydale Ave
fireguardss@gmail.com
City [Wes, Covina
State rCA
Zip (91790 Telephone 714-310-0194
f S. Engineer's Name
Last r
First �~ Lic No.
Engineer's Address
Engineer's E-mail Address
--
-
-
City=-- ----_
_ : State
Zip rTelephone[
jX 6. Contractor's Name
Last (Fireguard Spnnkler Systems First r�- Lic No. 992002
Class 16
Address
Contractor's E-mail Address
�Contractor's
l79G7 Leeds Street
— - --�
fireguardss@gmail.com
City Downey
State ICA
Zip 1902A2 Telephone 714-310-0194
OFFICE USE ONLY
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//jay-t ► PERMIT NO.
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TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
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PLAN CHECK NO. -
'I W PLAN CHECK FEE S -
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