HomeMy WebLinkAboutF2022-0072 - Permit ApplicationWorksheet for Fire Permit Application
11 LR0 City of Newport Beach - Building Department
Please print 3 copies Z ZU Z2�C_5,�k f 2011-10011
Associated Building Permit# �Z(6F-j Fire Sprinkler FR7 Fire Alarm F7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
100 BAYVIEW CIRCLE, NEWPORT BEACH, CA 92662 5600
Tenant Name # Units
2. Description of Wor Devices�
City Statezip
Installation of new visual an audio-visual notification appliances to provide proper coverage.,
Use
.. ... ..... . S
Extg Sq Ft New/Added Sq Ft F_' Total Sq Ft F05
Valuation $21362
1354 S. Parkside Pl.
# Stories F
6-7
F7 New F, Add Alter I-,! Demo
zip 91761 Telephone 9096287773
Check Appropriate Box for Applicant/Notification Information
Ell 3. Owner's Name Last
First
--- _-_-_-_-- --- --- ----- --
Owner's Address
Owner's E-mail Address
City Statezip
F Telephone
F- 4. Architect/Designer's Name Last Soukaria First Lic. No. 493
.. ... ... .... P 1905111 _J
Architect/Designer's Address
Architect/Designer's E-mail Address
1354 S. Parkside Pl.
englO@hcisystems.net
City jOntario StateF
zip 91761 Telephone 9096287773
F7 5. Engineer's Name Last First F Lic. No.
Engineers Address
Engineer's E-mail Address
City State
.... ......... ..... .. . .. .... ..... ....
Zip Telephone
Fx- 6. Contractor's Name Last 11 H I Cl Systems I - nc
First Lic. No. 905497 Class Pc1006
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside Pl.
Eng5@hcisystems.net
City Ontario State
ity F F77
zip F Fg
Telephone 09-957-5200
OFFICE USE ONLY PERMIT NO. 'F E_0_Z,-,7 - U U 7
TYPE OF CONSTRUCTION PLAN CHECK NO. QSq 6 2-SrL_Z-
OCCUPANCY - GROUPD-7 PLAN CHECK FEE $