HomeMy WebLinkAboutF2021-0403 - Permit Applicationirfftt .•
Worksheet for Fire Permit Application �rEW"rm
City of Newport Beach -Building Division
Please print 3 copies
Associated Building Permit # jXl Fire Sprinkler � Fire Alarm r; Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
i►NO W &y__Ave _ -� F �
Tenant Name # Units F
2. Description of Work
Flue S�i1Jlk�erS T(/f nib✓ Ji'�l _ ('1S i1QG1�s�_ Use �) JQ —�
Valuation $
Extg Sq Ft F— New/Added Sq Ft F_'. Total Sq Ft F_—;
# Stories
r New r Add r— Alter Iv Demo
Check Appropriate Box for Applicant/Notification
I -L_ _- _I: _.-
3. Owner's Name Last
First r � J
Owner's Address
Owner's E-mail Address
City State F
Zip
�� Telephoned._---.
(x 4. Architect/Designer's Name Last Vo
First John Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
City West Covina �W State CA
Zip
91790 Telephone 714 310 0194
r 5. Engineer's Name Last r-�--
First F_—.—. Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City — State I
Zip
F Telephoner
FX_ 6. Contractor's Name Last Fireguard Sprinkler Systems
First a Lic. No. 992002.
Class t 6
Contractor's Address
Contractor's E-mail Address
7907 Leeds Street
fireguardss@gmail.com
City Downey State CA
Zip
971 0242 Telephone 4-310 0194
OFFICE USE ONLY
PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
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OCCUPANCY - GROUP
I
PLAN CHECK FEE $
0 2,O )q —O 5 Oc)