HomeMy WebLinkAboutF2021-0512 - Permit ApplicationPrint Form Worksheet for Fire Permit Application dEW"�gT
Please print 3 copies City of Newport Beach - Building Division k4 = `
Associated Building Permit #
IF Fire Sprinkler j— Fire Alarm [ Fire Misc
1. Project Address (Not mailing address)
101 Newport Center Drive Floor Suite No
Tenant Name Cuyana Traveling Retail Store I���
#Units I 1
2. Description of Work
(Adding fire alarm system to new tenant suite.Uv
V�/ Use Retail
Extg Sq Ft 315 New/Added Sq Ft l V Valuation $ 6,400.00_
-- - Total Sq Ft 315
r New Add r Alter r Demo
#Stories 1
Check Appropriate Box for Applicant/ Otification
3. Owner's Name Last
_
Owner's Address --_ -_- First -
Owner's E-mail Address
City
�— - -._-- -- --.
(- 4. Architect/Designer's Name Last State Zip �Telephone�-
-._ — �
ArchitecUFirstLic.No.
Designer's Address -- ----
Architect/Designees E-mail Address
City _ tat
State �— Zip Telephoner. _._.....-.
Ix 5. Engineer's Name Last FSMART
Engineer's Address --' First FKAYLEEN
- ---. LicNo.�
3750 Schaufele Engineer's E-mail Address -------
kayleen smart@interfacesys.com
City Long Beach
State CA Zip 90808
- Telephoned'
FX 6. Contractor's Name Last SANTA -CRUZ
FirstKELLEY.-- Lic. No. 4(9046
Contractor's Address -- Class 10
3750 Schaufele Contractor's E-mail Address
Kelley. Santa Cruz@ i n terfa ces ys. co m
City Long Beach
State CA Zip 90808
-- Telephone562 353 4680
OFFICE USE ONLY r-2.02.1-0612 PERMIT NO. 1 2021 w 05 i 2
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP (� PLAN CHECK NO. ZSzZ� Z
W�LUZi - C�S7( PLAN CHECK FEE $