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Worksheet for Fire Permit Application
City of Newport Beach - Building Division � 401- axis
Associated Building Permit #
X2021-1530/X2021-1531 FX Fire Sprinkler F_ Fire Alarm I— Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
20282 RIVERSIDE DR
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Tenant Name FRIENDS OF NEWPORT BEACH
#Units
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2. Description of Work
NEW WET FIRE SPRINKLER SYSTEM FOR NEW FRIENDS OF NEWPORT BUILDING
2-C, S
Use
Extg Sq Ft F_ New/Added Sq Ft F_ Total Sq Ft
2,850
Valuation $ 21,000
# Stories
F
I— New F-Add r- Alter F_Demo
Check Appropriate Box for Applicant/Notification
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r 3.Owner's Name Last
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Owners Address
`row l Cf SCh Pgc�eF Owner's E-mail Address
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City
State F__ Zip F—Telephone Z/�-G5(-rn
4. Architect/Designer's Name
Last First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip [— Telephoned
r 5. Engineer's Name Last
First [_ Lic. No.
Engineers Address
Engineers E-mail Address
City
State I— Zip F Telephoned
F76. Contractor's Name Last A&D FIRE First F_ Lic. No. 0069002 Class 116
Contractors Address
Contractors E-mail Address
1601 W ORANGEWOOD AVE
CFURRER@ADFIRESPRINKLERS.COM
City ORANGE
State CA Zip 92868 Telephone 714-634-3923
OFFICE USE ONLY
p20Z[- w,53 PERMIT NO. ZOZZ � OU S
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TYPE OF CONSTRUCTION
PLAN CHECK NO. 110O
OCCUPANCY -GROUP
PLAN CHECK FEE $