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HomeMy WebLinkAboutF2022-0008 - Permit ApplicationWorksheet for Fire Permit Application o?EwP°qrm Print Form � i City of Newport Beach - Building Division o r Please print 3 copies °,�%.oa��' Associated Building Permit# r Fire Sprinkler r Fire Alarm F_ Fire Misc 1. Project Address (Not mailing address) Floor Suite No 4515 Orrington Rd., Corona Del Mar, CA 92625 I Tenant Name Units F 2. Description of Work Use SFR Design/build a 2-stories RESIDENTIALfire sprinkler system as per 2019 NFPA 13D - (59) heads. Extg Sq Ft F New/Added Sq Ft F_—Total Sq Ft 9,148 Valuation $ 9,500.00 # Stories New F_Add F—Alter F_Demo Check Appropriate Box for Applicant/Notification I nfn rm �4inn r 3. Owner's Name Last Family Trust First Pemba Owner's Address A Owner's E-mail Address 4515 Orrington Rd. City Corona Del Mar State CA Zip 92625 Telephone (949)-975-01223 r 4. Architect/Designer's Name Last First Lic. No.F Architect/Designer's Address Architect/Designer's E-mail Address City State Zip Telephone 5. Engineer's Name Last Vu First Anthony Lic. No. 1038755 Engineer's Address Engineer's E-mail Address 9559 Nightingale Ave ifireprotectiondesign@gmail.com City Fountain Valley State CA Zip 92708 Telephone (714) 234-9633 r?: 6. Contractor's Name Last Vu First Anthony 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 PLAN CHECK NO. OCCUPANCY - GROUP L �� > ©1 n PLAN CHECK FEE $