HomeMy WebLinkAboutF2021-0061 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fx Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
�.
",.,. F_ F_
520 Carnation Ave
- -
# Units F
Tenant Name
-. -....
2. Description of Work
Use
Fire sprinklers for new SFR (39 sprinklers)
-
--� -.-----..
Valuation $ 7,000
Extg Sq Ft NewlAdded Sq Ft �� Total Sq Ft
_.._ _..
# Stories 2
(- New Add 1 Alter I— Demo
-
Check Appropriate Box for Applicant/Notification
1- 3. Owner's Name Last First
Owner's Address
Owner's E-mail Address
City _ State F
Zip r Telephoner..
(x' 4. Arch itect/Designer's Name Last ivo
First John Lic. No.
Architect/Designer's Address
526 N Shadydale Ave
Architect/Designer's E-mail Address
fireguardss@gmail.com
City West Covina State CA
Zip 91790 Telephone 7143100194
F_ 5. Engineer's Name Last -- First r Lic No.
Engineer's Address
e
Engineer's E-mail Address
City _ State F__
Zip I Telephone
1x 6. Contractor's Name Last Fireguard Sprinkler Systems First Lic. No. 992002 Class 16
Contractor's Address
Contractor's E-mail Address
_
7907 Leeds Street
fireguardss@gmail.com
City Downey State CA
Zip 90242 Telephone 7143100194
OFFICE USE ONLY l�
l� PERMIT NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP ®
r PLAN CHECK NO.
QV PLAN CHECK FEE $
*&JAX