HomeMy WebLinkAboutF2025-5005 - Permit ApplicationWorksheet for Fire Permit Application
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I'rint FormCity of Newport Beach - Building Division
P ease print 3 copies
Associated Building Permit Fire Sprinkler I' Fire Alarm j— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2503 Eastbluff Drive I_ (_
Tenant Name Eastbluff Professional Building Emergency Replace I N Units F
2. Description of Work
Emergency Underground Fire Main Repair u(-_�_ Use
Valuation $ 16,000
Extg Sq Ft New/Added Sq Fi Total Sq Ft
r New Add r Alter F Demo 0 Stories F
+°1VU r+NNrUPI rtrieooxiorAp(Sllcant/Notitication
r 3.Owner's Name
Last �—
First F—
Owner's Address
Owner's E-mail Address
City
State ��
Zip I__ Telephone---.
(-'':4. Architect/Designer's
Name Last First— Lic. No. �—
Archilect/Designer's Address
Architect/Designer's E-mail Address
city
State
_ Zip �— Telephonef
G S. Engineer's Name
Last---
First f — -- Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City F—
State �—
Zip I- Telephoned---
r 6. Contractor's Name
Last Sais First Mike Lic, No, 1126139 Class C36,10,16
Contractor's Address
Contractor's E-mail Address
1170 E. Fruit Street
_
msaia@firesefetyfirst.com
city Santa Ana
State CA
Zip 92701 Telephone 714-329-7105
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $