HomeMy WebLinkAboutF2022-0117 - Permit ApplicationPrint Form Worksheet for Fire Permit Application ��W°�"r
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j` City of Newport Beach - Budding Division � rq
Please print 3 copies
Associated Building Permit# Fire Sprinkler (—Fire Alarm r— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
4607 Dorchester Road
Tenant Name _ # Units
2. Description of Work
Dire sprinklers for new SFR (47 heads)— — Use
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__ s
Valuation $ �7,000
Extg Sq Ft _ New/Added Sq Ft � Total Sr, Ft j
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#Stories
y ( New F` Add j Alter ( Demo I
heck Appropriate Box for Applicant/Notification
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1 3. Owner's Name
Last i First
s,
Address
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Owner's E-mail Address
,Chvner's
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4p� ity
State F Zip—� Telephone—i---
P R 4. Architect/Designer's
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—
Name Last Vo First Fjohn Lic. No.I
Architect/De-signer's Address
526 N Shadydale Ave
Architect/Designer's E-mail Address
fiieguardss@gmail.com I
cityWest Covina
State CA Zi 91790 Telephone ;,143100194 -
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F` 5. Engineer's Name
Last First I-ic. No'
_ — — I
Engineer's Address
Engineer's E-mail Address
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City F
State I Zip) '_ Telephone)
i 8. Contractor's Name
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Last Fireguard Sprinkler Systems First Li No.yz002 Class 16
Contractor's Address
�7907 Leeds Street
_ Contractor's E-mail Address 4
` fireguardss@gmail.com
City Downey
State CA Zip 90242 Telephoner7143100194
OFFICE USE ONLY
PZ . D PERMIT NO.
TYPE OF CONSTRUCTION _— CCCCJJJ����Ifff PLAN CHECK No
OCCUPANCY I - GROUP 2 ce)wPLAN CHECK FEE $ -- ---