HomeMy WebLinkAboutF2021-0627 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
(x Fire Sprinkler I— Fire Alarm r Fire Misc
�EwroRr
1. Project Address (Not mailing address) rFloor Suite No
2500 Marino Drive, Newport Beach _ I
Tenant Name # Units
2. Description of Work 1111
NFPA 13D Fire Sprinkler System Use I
Valuation $ 13,970
Extg Sq Ft F NewlAdded Sq Ft F— Total Sq Ft 5,249
r New r" Add r Alter r Demo l9a V�eacl5
# Stories I -
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
(y1
First
Owner's Address
Owner's E-mail Address
City _ __.
State r-
Zip TelephoneF_
(x' 4. Architect/Designer's Name Last
Gutierrez
First Rubi Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
8085 E. Crystal Dr.
RubiG@resfire.com
City Anaheim
State CA
Zip 92807 Telephone (714)666-8450
r 5. Engineer's Name Last I First I Lic. No.l
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F_ Telephoner
6. Contractor's Name Last _Residential Fire Systems
First I — Lic No. 786965_ _ Class c-16
Contractor's Address
Contractor's E-mail Address
8085 E. Crystal Dr.
engineering@resfire.com
City Anaheim
State CA
Zip 92807 Telephone (714)666-8450
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION —
PLAN CHECK NO.
OCCUPANCY- GROUP
XI• I �� PLAN CHECK FEE $