HomeMy WebLinkAboutF2024-0572 - Permit ApplicationPrint Form
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c�OWPORT
Worksheet for Fire Permit Application o
City of Newport Beach - Building Division '� .
(— Fire Sprinkler X Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
20321 IRVINE AVENUE, NEWPORT BEACH, CA. 92660
Tenant Name �AYSIDE SURGICAL CENTER
2. Description of Work
NSTALL AUTOMATIC & MANUAL FIRE ALARM SYSTEM WITH OCCUPANT NOTIFICATION FOR
FHIS TENANT IMPROVEMENT.
Extg Sq Ft F_
New/Added Sq Ft �� Total Sq Ft
X New F_ Add r Alter r Demo
Check Appropriate Box for Applicanvlvoancailon
I— 3. Owner's Name Last
Owner's Address
City
State �-
4. Architect/Designer's Name Last
Architect/Designer's Address
City State
r 5. Engineer's Name Last
Engineer's Address
First
Owner's E-mail Address
Floor SuNo
�
F- f`
# Units F.—
Use URGICAL CENTER
Valuation $ ,580
# Stories F
Zip Telephoned ---
First �— Lic. No.
Architect/Designer's E-mail Address -
r'y
First
Engineer's E-mail Address
Lic. No.
--
City F— State F_— Zip [_ TelephoneF_
F;7 6. Contractor's Name Last AY ALARM COMPANY First-- Lic. No. 80138 Class 10
Contractor's Address
590 S. LEWIS ST.
City FNAHEIM State FA Zip
Contractor's E-mail Address
ICHOLAS.MOSS@BAYALARM.COM
2805 Telephone 14-300-8639
OFFICE USE ONLY PERMIT NO. 1 0�y74 — r GQ
TYPE OF CONSTRUCTION
PLAN CHECK NO RM4 -' 01
OCCUPANCY - GROUP PLAN CHECK FEE $