HomeMy WebLinkAboutF2021-0507 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I P Zb 1�( — 5 L Z�7 r Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
23 Harbor Island, Newport Beach F I
Tenant Name # Units I
2. Description of Work wr
NFPA 13D Fire Sprinkler System Use
r Valuation $ 21,610
Extg Sq Ft New/Added Sq Ft I Total Sq Ft 5.724 IxNew r Add r Alter r Demo BI.P �S#Stories(20
Check Appropriate Box for Applicant/Notification
r 3.Owner's Name Last
First
Owners Address
Owner's E-mail Address
City—
__. State
Zip— Telephone—
r 4. Arch itecUDesigner's Name
Last Gutierrez
First Rubi Lic. No.�
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
(- 5. Engineer's Name Last I—
First F—Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City I—
State —
Zip I — Telephoned—
rx— 6. Contractor's Name Last Residential Fire Systems
First— 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
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t-76 PLAN CHECK FEE $