HomeMy WebLinkAboutF2021-0400 - Permit ApplicationWorksheet for Fire Permit Application
— _1 I—' I City of Newport Beach - Building Department
Please print 3 copies
Associated Building Permit #
Fire Sprinkler Fire Alarm
VZ041- 01.110
F7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1 330 -_ 0 - Id - Newport 11 Boulevard, 11 I I - I I - Newport - Beach, CA , 92660 1 1111111F77
-Yb WE
Newport # u
1nits
Tenant Name USC Old ort Pharmacy MOB F -1 - - I-,----- _-1 ----- t�_ A -
2. Description of Work Area of Refuge System Total 8 Devices
Use Fire Alarm
Installation of New Rah Area of Refuge (AOR) System, Rath Power supply, and AOR call
stations.
Extg Sq Ft —New/Added Sq Ft Total g -'F -t 0'4
Valuation$ 7,162.50
F
�2,,5�
- --- ---- - -- --- -----
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Zip 190245' Telephone F(562)299-2047
F7 New F
F7 Add x- Alter Demo \30
# Stories
F7
First Vanessa Lic. No. 905493
Architect/Designees Address
Check Appropriate Box for Applicant/Notification Information C�J'
F?Z, 3. Owner's Name Last Lee
First Sophia
Owner's Address
Owner's E-mail Address
2221 Rosecrans Avenue, Suite 200
I
City 1B Segundo
State CT
CA
- --- ---- - -- --- -----
r
Zip 190245' Telephone F(562)299-2047
4. Architect/Designer's Name Last
Montoya
First Vanessa Lic. No. 905493
Architect/Designees Address
Architect/Designer's E-mail Address
4585 Murphy Canyon Rd
Ivrn ont oy a @ hc isyste m s.n at
City ISan Diego
State CA
- I - I
Zip 92123 Telephone[( 858) 560-7000gI
F7 5. Engineer's Name Last
First7 1 Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State
F777
.. .. ........ .... . .....
Zip Telephone
F777 F
fx—.6. Contractor's Name Lastj5VIFaT First Lic. No. F905493 Class
Fsam� 1
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside Pl.
Eng5@hcisystems.net
City jOntario
State [CA
Zip 9176TelephoneF�-628-7773
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO.
AD -14 q 10
PLANCHECKNO.
OCCUPANCY- GROUP
VV1 A (I (I ej
PLAN CHECK FEE $