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Associated Building Permit #
Worksheet for Fire Permit Application o��EW�Re
City of Newport Beach -Building Division
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j� Fire Sprinkler rX Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
8 00-984 AVOCADO AVE
Tenant Name ALCHEMY 43
2. Description of Work I I /u'�v {'fit_ -
TO REPLACE A LOCKED OUT PANEL TO PROGRAM NEW DUCT DETECTOR MONITORING IN 906
SUITE AS REQUIRED BY APPLICABLE CODES.
Extg Sq Ft r New/Added Sq Ft Total Sq Ft
F New I— Add rX Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
_ 906
#Units I_
Use
Valuation $ 2000.00
# Stories
F 3. Owner's Name Last Hardesty + Associates
First
Owner's Address
Owner's E-mail Address
711 W. 17th Street Suite D2
City Costa Mesa State CA
Zip 92660 Telephone
F 4. Architect/Designer's Name Last I
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State—
Zip Telephone
F 5. Engineer's Name Last SETTLEMOIR
First MASON Lic. No. F469046
Engineer's Address
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH State CA
Zip 90808 Telephone 1 5623534680
F-6. Contractor's Name Last INTERFACE SYSTEMS First Lic. No. 469046 Class C10
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200
kelley.santacruz@interfacesys.com
City LONG BEACH State CA
Zip 90808 Telephone 5623534680
OFFICE USE ONLY
PERMIT NO. m)y
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP /2)t l PLAN CHECK FEE $
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