HomeMy WebLinkAboutF2022-0179 - Permit ApplicationWorksheet for Fire Permit Applic
Rrint Form City of Newport Beach - Building Departme
Please print 3 copies T,,W1.-01*
Associated Building Permit # r Fire Sprinkler f—x, Fire Alarm I— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
100 Bayview Circle F 5100
Tenant Name 1_ Johnson Attorney Group Units I'll, 11 F
2. Description of Work
L—A
se
Installation of new audio-visual appliances
Valuation $
I I
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft F61
-
New (-Add Alter F7 Demo
# Stone
(0-
Check Appropriate Box for Applicant/Notification Information
F- 3. Owner's Name Last Edwards First Jeannie
Owner's Address Owner's E-mail Address
100 Bayview Circle Suite 230
ljedwards@graniteprop.com
City [Newport Beach State [EA ZIP 92660 Telephone 818-265-7511
rz:,Achits Designer's Name tj�ft
First Lic. No.
-_
Address,,,,
t/Drs F77
Architect/Desits Address,7� �Architect/D sign is E-mail Address'
City State ZIP Telephone
5. Engineer's Name Last First F Lic. No.
Engineers Address Engineer's E-mail Address
I. .. . . .. . .. .. ................. .. . .
City StateF77 Telephone zip F
[76. Contractor's Name Last Williams First Dominique Lic. No. 905493 Class[c7c10c16
Contractor's Address Contractor's E-mail Address
1354 S. Parkside Pl.
Eng5@hcisystems.net
City jOntario State FCA zip 91761 Telephone 909-957-5200
OFFICE USE ONLY PERMIT NO
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP v PLAN CHECK FEE $