HomeMy WebLinkAboutF2022-0602 - Permit Application�EWM?T
-� Vllorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division h
. .
Please print 3 copies
Associated Building Permit# � �1—, ` Fire Sprinkler F Fire Alarm I Fire Misr
1. Project Address (Not mailing address)
434 Via Lido Nord --��
Tenant Name F
2. Description of Work
1Fire sprinklers for new SFR (31 heads) —
Extg Sq Ft New/Added Sq Ft Total Sq Ft i
Floor
Suite No
a Units
Use
Valuation.$ r6,000 �W
# Stories
(- New j- Add r Alter I— Demo
Check Appropriate Box for Applicant/Notification
I fl 4'r
(- 3.Owner's Name Last
First j�
i Owner's Address
Owner's E-mail Address
________.--..
City State
I�
_ t
Zip Telephone
tX 4. Architect/Designer's Name Last 1Vo
First John Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
City West Covina State
CA Zip [91790 Telephone!714 310-0194 j
j- 5. Engineer's Name Last
First F Lic. No. i
Engineer's Address
Engineer's E-niail Ad dress
Oity State
Zip Telephoned
x 6. Contractor's Name Last Fireguard Sprinkler Systems First Lic. No. '992002 Class t6
Contractor's Address
Contractors E-mail Address
Leeds Street
fireguardss@gmail.com
47907
City Downey �— State
—
CA Zip F90242 TeiephoneI714-310-0194 I
ZL
OFFICE USE ONLY
PERM17 NO �Z2SUL � DGO
TYPE OF CONSTRUCTION —_
PLAN CHECK NO.
OCCUPANCY -GROUP
026Z1 — 0' IpL$yN CHECK FEE $