HomeMy WebLinkAboutF2021-0448 - Permit ApplicationErint Form Worksheet for Fire Permit Application
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Please print 3 copies W�-�\ V " " "(/ V
Associated Building Permit #
1. Project Address (Not mailing address)
1343 Mariners Drive, Newport Beach, CA 92660
Tenant Name
2. Description of Work
iX Fire Sprinkler F_ Fire Alarm I— FireMisc
Floor Suite No
# Units F—
ild a 2-stories RESIDENTIAL fire sprinkler system as per 2019 NFPA 13D - (30) heads.
Extg Sq Ft 2,580 New/Added Sq Ft 1 5593 Total Sq Ft 4,173
Use SFR
Valuation $ 4,900.00
IX New r Add r Alter r Demo I # Stories I
Check Appropriate Box for Applicant/Notification
IX 3. Owner's Name
Last Kieny First Bergen
Owner's Address
Owner's E-mail Address
1343 Mariners Drive
City Newport Beach
State CA Zi 92660
p Telephone (747) 265-0079
(— 4. Architect/Designer's
Name Last First F Lic. No.
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
City F_
State F— Zip rs— TelephoneF_
5. Engineer's Name
Lic No. �--_--`
Last Vu First Anthony 1038755
Engineer's Address
9559 Nightingale Ave
_ Engineer's E-mail Address
ifireprotectiondesign@gmail.com
City Fountain Valley
State CA Zi 92708
— p — Telephone (714) 234-9633
FX-6. Contractor's Name
Last Vu First Anthony Lic. No. 1038755 Class C16
Contractors Address
Contractor's E-mail Address
9559 Nightingale Ave
ifireprotectiondesign@gmail.com
City Fountain Valley
State CA Zip2708
9Telephone (714) 234-9633
OFFICE USE OJVLY
PERMIT O
O I O
TYPE OF CONSTRUCTION
JPLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $