HomeMy WebLinkAboutF2022-0497 - Permit ApplicationPrint Form
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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing addri
4601 Dorchester Road
Tenant Name
2. Description of Work
Fire sprinklers for new SFR (34 sprinklers)
V Fire Sprinkler F_ Fire Alarm j— Fire Misc
Extg Sq Ft F—', New/Added Sq Ft Total Sq Ft
F_ New (`. Add r— Alter Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units I
Use
Valuation $ F o0
# Stories
f 3. Owner's Name
—
Last to First F-7
Owner's Address
Owner's E-mail Address
r
City r
State—� Zip Telephonee^—
DK 4. Architect/Designer's
Name Last 1" First Kohn Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmaiLcom
city West Covina
State r6A Zip 91 /90 _ Telephone 714-310-0194
F 5. Engineer's Name
Last First ��. Lic. No, i
Engineer's Address
Engineer's E-mail Address
City
State— Zip Telephone
II—-
6. Contractor's Name
—
Last Fireguard Sprinkler Systems First e�� Lie. No. 1992002 Class i 16
Contractor's Address
7907 Leeds Street
Contractor's E-mail Address
fireguardss@gmaiLcom
City Downey
State EA zip 190242 Telephone 714-310-0194 _
[OFFICE USE ONLY
PERMIT NO. 0*9%a
p(O _LK/ZZ—
TYPE OF CONSTRUCTION V PLAN CHECK NO. �CZOZZ� Z�%C
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OCCUPANCY -GROUP
p VI/ PLAN CHECK FEE $ -----