HomeMy WebLinkAboutF2021-0186 - Permit Application'PriritFoWorksheet for Fire Permit Application
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'�( City of Newport Beach - Building Division
Please print 3 copies ./\
Associated Building Permit X2019-3882 r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Newport Medical 5020 �—
Tenant Name Newport Medical # Units F
2. Description of Work VD
Relocate Existing 4" main + Relocate (23) pendent sprinklers, add (3) pendent, and add (10) Use V -B / B
Upright sprinklers
Valuation $ 10,000
Extg Sq Ft New/Added Sq Ft �— Total Sq Ft 11,458 '
r New r; Add r Alter r / Demo #Stories 1
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Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
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City _ _ State �, Zips Telephone
r 4. Architect/Designer's Name Last
Lic. No.
Architect/Designer's Address Architect/D�i r �r's E-;61 Address
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city
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City; State Zip —� Telephone
r 5. Engineer's Name Last First Lic. No. J
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J .......... . _...
Engineer's Address Engineer's E-mail Address
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City .... ._.� State Zip Telephoned
r 6. Contractor's Name LastCJ Suppression, Inc. First �— Lic. No. 721124 Class C-16
Contractor's Address Contractor's E-mail Address
205 Lewis Court robin@cjsuppression.com
_._._
City Corona State CA Zip 92882 Telephone 951-735-5560
OFFICE USE ONLY�' PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO IryJ
PLAN CHECK FEE $
OCCUPANCY- GROUP
MUM