HomeMy WebLinkAboutF2023-0368 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address I
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
address)
12280 NEWPORT BLVD, NEWPORT BEACH, CA
Tenant Name RUMBLE
2. Description of Work
rx- Fire Sprinkler r Fire Alarm F_ Fire Misc
THIS T.I. INVOLVES ADDITION & RELOCATION OF EXISTING FIRE SPRINKLER DROPS FOR NEW
WALLS/ROOM CONFIGURATIONS
Extg Sq Ft �— New/Added Sq Ft '4 Total Sq Ft 2,684
r New F_ Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
101
# Units
Use
Valuation $ 11,275.00
# Stories 1
F 3. Owner's Name Last F
First
Owner's Address
Owner's E-mail Address
City
State I Zip Telephone[
4. Arch itecUDesigner's Name Last LOPEZ First PAUL Lic. No. 1069002
Architect/Designer's Address
Architect/Designers E-mail Address
1601 W ORANGEWOOD AVE
PLOPEZ@ADFIRESPRINKLERS.COM
City ORANGE
State CA Zip 92868 Telephone 714-634-3923
5. Engineer's Name Last
First F Lic. No.
Engineer's Address
Engineer's E-mail Address
Ciry
State F_ Zip F_— Telephone
(- 6. Contractor's Name Last
First A& D FIRE Lic. No. 1069002 Class C-16
Contractor's Address
Contractor's E-mail Address
1601 W ORANGEWOOD AVE
PLOPEZ@ADFIRESPRINKLERS.COM
City ORANGE
State CA Zip 92868 Telephone 714-634-3923
PERMIT NO. D2I�
OFFICE USE ONLY
(E9
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
y PLAN CHECK FEE $
1
912— %-<*