HomeMy WebLinkAboutF2023-0244 - Permit ApplicationWR
----------- Worksheet for Fire Permit Application
L._- Print Form )
City of Newport Beach -Building Division
3. .
Please print 3 copies °
Associated Building Permit # XR2022-2117 — Fire Sprinkler T- Fire Alarm i Fire Misr
1. Project Address (Not mailing address) s Floor Suite No
11b18 Highland Drive.. ..._
Tenant Name 1
2. Description of Work
Fire sprinklers for SFR (48 heads)
Extg Sq Ft i _ New/Added Sq Ft Total Sq Ft
( New [ Add ( Alter Demo
Check Appropriate Box for ApplicantlNotif!cation
# Jnits � 1
Use
Valuation $ 19,00o
+
Stories
(-' 3. Owner's Name
Last _.-
Frst 1
Owner's Address
Owner's E-mail Addre-_$ I
City
State
=ip 1 Telephornel
4. Architect/Designer's
Name Las+ `l+-+
Firs + Joho Lic. No. j
i
l Architect/Designer's Address
Aichitect4:esigners E :nail Address
526 N Shadydale,A.ve
'f+Aguards @gmail.com
i City West Covina V-
S tj re CA
91 75O - Teiephon= 714 3'10-0194
5. Engineer's Name
Last
Lic. Na.
Engineer's
Eng'Address
nl -rt e 's E-mail A dr'.=s
.— .
.
City a
-.
:state ?
't
Zip 1 Telephonel i
-.. -_ -...
6, Contractor's Name
Last jFuegua d Sp nKla Sy, rns Fi ,i Lic.,No. 1992002 Class 16
i 3 +
Contractors Address
Contractor's E-mail Address
17907 Leeds Street
ifireguardssra7gmail.com
City Downey
r
Sate (CA
Zipi902427elephone'+14-210-0194
OFFICE USE ONLY
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I A' — - - PERMIT NO.. -
TYPE OF CONSTRUCTION _ n � PLAN CHECK NO.
OCCUPANCY - GROUP —� d PLAN CHECK FEE $ -- - -