HomeMy WebLinkAboutF2019-0608 - Permit ApplicationOUO
Print FoWorksheet for Fire Permit Application
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City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # r Fire Sprinkler FXT Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
807 NEWPORT CENTER DRIVE
F—
807
Tenant Name LORNA JANE
# Units
�-
Name Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
2. Description of Work
Telephon
State F_ Zip r e
r 5. Engineer's Name
PROTECTED PREMISES FIRE ALARM SYSTEM n by, po I
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Engineer's E-mail Address
h PJOT%..
City LONG BEACH
State CA Zip 90808 Telephone 562-353-4680
F_ 6. Contractor's Name
Valuation $
5,500.00
Extg Sq Ft F New/Added Sq Ft � Total Sq Ft
3750 SCHAUFELE AVE SUITE 200 KELLEY.SANTACRUZ@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone662-353-4680
#Stories
F_ New r Add r Alter (— Demo
O �3 PLAN CHECK FEE $
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name
Last H A BUILDERS First 7—
Owner's
Owner's Address
Owner's E-mail Address
14796 WILD COLT PL
City JAMUL
State CA Zip 91935 Telephone 619-669-1183
F_ 4. Architect/Designer's
Name Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
Telephon
State F_ Zip r e
r 5. Engineer's Name
Last PETTY First PAUL Li4 469Q4�
((JJ
Engineer's Address
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200 PAUL.PETTY@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone 562-353-4680
F_ 6. Contractor's Name
Last INTERFACE SYSTEMS First 7 Lic. No.69046 Class C10
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200 KELLEY.SANTACRUZ@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone662-353-4680
OFFICE USE ONLY PERMIT NO. D(� m DCP D
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
O �3 PLAN CHECK FEE $