HomeMy WebLinkAboutF2022-0076 - Permit ApplicationPrint Form Worksheet for Fire Permit Application 0111-_k>
City of Newport Beach -Building Division4,
Please print 3 copies
Associated Building Permit # fX Fire Sprinkler f—Fire Alarm
r Fire Misc
1. Project Address (Not mailing address)
434 Fernleaf Ave., Corona Del Mar, CA 92625 Floor Suite No
Tenant Name # Units
2. Description of Work
Design build a new 3 -story overhead RESIDENTIAL fire sprinkler system in accordance with Use SFR
2019 NFPA 13D - (42) sprinkler heads,
Extg Sq Ft �`'' New/Added Sq Ft 3,528... Total Sq Ft 3,528
FX_ New r Add j– Alter
F_ Demo
Check Appropriate Box for Applicant/Notification
Infnrmatl0
r 3. Owner's Name Last Pembroke -Martin
First John &Karen
_. _ _
Owner's Address
Owner's E-mail Address
1724 Port Margate Place
Valuation $ 6,600.00
# Stories i
City INewport Beach State CA –
ZiP 92660 Telephone (949) 278-0541
F_ 4. Architect/Designer's Name Last
F� Lic. No. F777Architect Designer's Address Architect/Designer's E-mail Address
City �— State [_ Zip Telephoner,
FX_ 5. Engineer's Name Last
First Anthony Lic. No. 1038755
Engineer's Address
Engineer's E-mail Address
9559 Nightingale Ave
ifireprotectiondesign@gmail.com
City IFountain Valley StateCA ZIP 92708 Telephone (714) 234-9633
r6. Contractor's Name Last Nguyen First Vincent
Lic. No. 1084661 'ClassC16�'
Contractor's Address
Contractor's E-mail Address
9182 Alwick Circle xfirerotection
p 9 rou P@9mail.com
City lGarden Grove State CA Zi 92841
P Telephone(714) 231-5108
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO. � V •�_
OCCUPANCY- GROUP
��� I!lItILZ. PLAN CHECK FEE $