HomeMy WebLinkAboutF2023-0356 - Permit ApplicationWorksheet for Fire Permit Application
Print Form z ;�
City of Newport Beach - Building Division �
Please print 3 copies oa "
Associated Building Permit #
XC2022-1892 r Fire Sprinkler FX_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1101 Newport Center Dr
Tenant Name Restoration Hardware # Units
2. Description of Work
Use A2, B, M
Design and install fire alarm.
Extg Sq Ft 72,926 New/Added Sq Ft Total Sq Ft 72,926
Valuation $ 70,000
# Stories
(x New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Informatuou
F_ 3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City
State F__ Zip F_ Telephoned
F 4. Architect/Designer's
Name Last First F_ Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F— Zip F Telephoned
r 5. Engineer's Name
Last First F__ Lic. No. �— -
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F Telephoned
FT 6. Contractor's Name
Last Shiota First Brandon Lic. No. 961901 Class C-7, C-10
Contractor's Address
Contractor's E-mail Address
141 E. Arrow Hwy.
brandons@avcomsystems.com
City San Dimas
State CA Zip 91773 Telephone 626-310-7433
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
j� , DO PLAN CHECK NO. T����
OCCUPANCY - GROUP
PLAN CHECK FEE $