HomeMy WebLinkAboutF2022-0273 - Permit Application-F 2022 - 02 7-7
Worksheet for Fire Permit Application Vz
City of Newport Beach - Building Department (11 go —
Please print 3 copies
Associated Building Permit# f7 Fire Sprinkler fJ—F, Fire Alarm 17 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
100 Bayview Circle, Newport Beach, CA 92660 3600
Tenant Name # Units
.. .. ........
2. Description of Work
Us
Installation of new visual and audio-visual notification appliances
Valuation$ [1235
Extg Sci Ft J6200 New/Added Sci Ft F Total Sq Ft
�New F-, Add Fx-, Alter Demo #Stories (16 F'
Check Appropriate Box for Applicant/Notification Information
3. Owner's Name Last
First
F77777
Owner's Address
Owner's E-mail Address
City
F
State F77
Zip F Telephoner
4. Architect/Designer's Name Last
jSripipalt
First Sarintip Lic. No.
F777
Architect/Designer's Address
Architect/Designer's E-mail Address
1354 S. arkside Pl.
City jOntaric,
State [EA
. ..... ... .... . ... ... .. . .
Zip �7617 Telephone[9N-957-UN
F-'5. Engineer's Name Last
First Lic. No.F�
Engineer's Address
Engineer's E-mail Address
City
State F
. . ... .. .... ... .. . ....... .. ..... . .. ... ... . .. . ..
ZipF Telephonel
F- 6. Contractor's Name Last.Williams First Porninique Lic. No. F05493 Class 7clOcl6
Fc
Contractor's Address
Contractor's E-mail Address
1354 11 11 - S. Pa I rkside - P1.
[Eng5@hcisystems.net
City Ontario
State Fc
zip 191761 Telephone 09-628-7773
F9
OFFICE USE ONLY
CJ�OA
6"_ PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
/m �
7z-e
,
PLAN CHECK FEE $
1
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