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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
[x Fire Sprinkler F_ Fire Alarm I— Fire Misc
1. Project Address (Not mailing address)
419 Narcissus Ave., Corona Del Mar, CA 92625
Tenant Name
2. Description of Work
Design build a new 3-story overhead RESIDENTIAL fire sprinkler system in accordance with
2019 NFPA 13D - (45) sprinkler heads.
Extg Sq Ft New/Added Sq Ft 3,325 Total Sq Ft 3,325
(x New F_ Add (— Alter I— Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use SFR
Valuation $ 6,100
# Stories [3-
(x 3. Owner's Name
Last Chegini First Michael
Owners Address
Owner's E-mail Address
419 Narcissus Avenue
City Corona Del Mar
State CA Zip 92625 Telephone (949) 289-8990
F_ 4. Architect/Designer's
Name Last First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip-- Telephoner _
r 5. Engineer's Name
Last Vu First Anthony Lic. No. 1038755
Engineer's Address
Engineer's E-mail Address
11621 W. Sumac Lane
ifireprotectiondesign@gmail.com
City Anaheim
State CA Zip 92802 Telephone 7714) 234-9633
Ix 6. Contractor's Name
Last Nguyen First Vincent Lic. No. 0084661 Class C16
Contractor's Address
Contractor's E-mail Address
9182 Alwick Circle
xfireprotectiongroup@gmail.com
City Garden Grove
State CA Zip 92841 Telephone (714) 231-5108
OFFICE USE ONLY
PERMIT NO. F2 2-7-- 016 t
TYPE OF CONSTRUCTION
PLAN CHECK NO.
I✓
OCCUPANCY- GROUP
Z PLAN CHECK FEE $
J,tZ-o22-(1st 7