HomeMy WebLinkAboutF2023-0092 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application 04%;
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
5000 Birch Street
Tenant Name
2. Description of Work
labor to install 13 Notification Devices.
Extq Sq Ft F__ _ New/Added Sq Ft F Total Sq Ft
r New r Add F- Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
1000
# Units F
Use
Valuation $ 19,875.00
# Stories F
F_ 3. Owner's Name Last Insurance Company USA First John Hancock Life
Owner's Address
Owner's E-mail Address
5000 Birch Street, Suite 120
City Newport Beach State CA- '
Zip 92660 Telephone —
F_ 4. Architect/Designer's Name Last
First 7 Lic. No.
F
Architect/Designer's Address
Architect/Designer's E-mail Address
City �— _ - State F___
Zip F_ Telephoned
[5. Engineer's Name Last
... First Lic. No..
Engineer's Address
Engineer's E-mail Address
City State 7—
Zip F_ Telephoned
F?Fc 6. Contractor's Name Last Diaz
First Natalie Lic. No. 599761 Class C10,16,36
Contractor's Address
Contractor's E-mail Address
1170 E. Fruit Street
ndiaz@firesafetyfirst.com
City Santa Ana State CA
Zip 92701 Telephone 714-263-2832
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $