HomeMy WebLinkAboutF2021-0478 - Permit ApplicationPrint Forme
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
579 NEWPORT CENTER DRIVE
Tenant Name I LO YOGA - SUITE 579
2. Description of Work
Fire Sprinkler r Fire Alarm f— Fire Misc
Floor Suite No
579
# Units
tll�
Extg Sq Ft F�
New/Added Sq Ft F—
Total Sq Ft
t3 �N\r
New Add r Alter (— Demo
13 ,Nat's
Check Appropriate Box for Applicant/Notification
.T._— Use I -.
Valuation 5 7000.00.
# Stories F_
3. Owner's Name Last DR CONSTRUCTION INNOVAT, Firstf
Owner's E-mail Address
Owner's Address
28831STARTREELANE
city SANTA CLARA State CA
r 4. Architect/Designer's Name Last I
Architect/Designer's Address
State �—
zip 191390 TelephoneF�
First
Architect/Designer's E-mail Address
Zip F— Telephone
city I
Last SMART First KAYLEEN Lic. No. 69046
r— 5. Engineer's Name
Engineer's E-mail Address
Engineer's Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
r 6. Contractor's Name Last INTERFACE SYSTEMS First
�—
Lic. No. 69046 Class C10
Contractor's E-mail Address
Contractor's Address
s.com
3750 SCHAUFELE AVE SUITE 200
kelley. santacruz@interfacesy
City LONG BEACH
State CA Zip 90808 Telephone 562-353-4680
Lic. No.
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $