HomeMy WebLinkAboutF2019-0640 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Department rr-2011064(9
Please print 3 copies
Associated Building Permit # r Fire Sprinkler Ix Fire Alarm r Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
100 Bayview Circle Newport Beach CA 92660 2200
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71,
Tenant Name# Units
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2. Description of Work
1500 RosecransAve Suite 500
Installation of new visual and audio/visual notification appliances. Removal of Notification
Use
Devices. 4 new devices 9 devices removed
4. Architect/Designees Name Last
___ __- -----
Valuation $ 2,715.00 i
Extg Sq Ft New/Added Sq Ft F77777 Total Sq Ft 3 350
1354 S. Parkside PI.
City Ontario
State CA j Zip 91761 Telephone909-957 5200
# Stories 6
NewF Add )( Alter [-; Demo
Engineer's Address
Check Appropriate Box for Applicant/Notification Information
(- 3. Owner's Name Last Hanks First h
Jon-- ®
- - - ' - - ---- -
Owners Address
Owner's E-mail Address��
1500 RosecransAve Suite 500
GO
City Manhattan Beach v
StateCA Zip 90266 Telephone
4. Architect/Designees Name Last
Padua First Beth Lic. No. j
Architeci/Designer's Address
____
Architect/Designer's E-mail Address
1354 S. Parkside PI.
City Ontario
State CA j Zip 91761 Telephone909-957 5200
r 5. Engineer's Name LastFirst
Lic. No. F 71111
Engineer's Address
Engineer's E-mail Address
- -
City
._ .._..
State F Zip [7777 Telephoned
(X 6. Contractor's Name Last HCI Systems Inc First Lic. No. 905493
F -- Class c7c10c16
_ . --- — - - - — 1 —
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside PI.
Eng5@hcisystems.net
City O 11 nta11 11 ri11 o
State CA zip 81761 , Tele hone 909-957-5200 I
OFFICE USE ONLY
/ PERMIT NO.
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TYPE OF CONSTRUCTION(�
t�U ✓ PLAN CHECK NO!-" ( � tl
OCCUPANCY- GROUP
l�/j 'RS v 0 PLAN CHECK FEE $