HomeMy WebLinkAboutF2022-0210 - Permit Application62 10 Worksheet for Fire Permit Application
City of Newport Beach - Building Department
Please print 3 copies
Associated Building Permit #
F Fire Sprinkler r; Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
120411 Southwest I - Birch - Bldg. B, _ St Newport - - Beach, CA - 92660
Tenant Name I Ferrado Bayview C/O C BRIE LL C # Units
2. Description of Work
Replace existing sprinkler monitoring system, installation of new fire alarm communicator, Use
replacement of existing audio-visual notification appliance
Valuation $ 1,609
Extg Sq Ft F1 672 New/Added Sq Ft F Total Sq Ft F
F7 Add I)—(, Alter F Demo # Stories
F New F
Check Appropriate Box for Applicant/Notification Information
3. Owner's Name Last Osburn First Traci
Owner's Address Owner's E-mail Address
400 MacArthur Blvd Suite 350 @cbrecom.
Fra . .... .. ... .. .. .
City INewport Beach State F zip 92660 Telephone 49)955-2131
F)(, 4. Architect/Designees Name Last Valenzuela First Lic. No.
I 11,111 1: F F
Architect/Designer's Address Architect/Designees E-mail Address
F1354 S. Parkside Pl.
City JOntario State ICA ZIP 91761 (909)628-7773
5. Engineer's Name Last First F Lic. No.
Engineer's Address Engineers E-mail Address
. . . . .. ... .... .. ... .. .. .... ... .. ... .
City State zip TelephoneF
6. Contractor's Name Last Williams First [Dominique Lic. No. 1905493 Class Fc7c`Ocl�
Fx—�,
Contractor's Address Contractor's E-mail Address
1 1354 S. Parkside PI. Eng5@hcisystems.net
OntarioStateState
'ity F9O9 957-5200
Telephone
Fo [E�77 zip Fg1761
�E USE ONLY PERMIT NO.
OF CONSTRUCTION PLAN CHECK NO.
tkNCY - GROUP PLAN CHECK FEE $