HomeMy WebLinkAboutF2021-0309 - Permit Application1. Print Form
Please print 3 copies
Associated Building Permit #
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Worksheet for Fire Permit Application of Rm�
City of Newport Beach - Building Division
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J -LOZl C) (– Fire Sprinkler rX Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
313 NEWPORT CENTER DRIVE (y sj 303.
Owner's E-mail Address
Tenant Name MADISON REED # Units
2. Description of Work
Use 2
PROTECTED PREMISES FIRE ALARM SYSTEM
F— 4. Arch itect/Designer's Name Last
Valuation $ 10,000.00
Extg Sq Ft F_New/Added Sq Ft F Total Sq Ft
Architect/Designer's E-mail Address
City State F_
# Stories
F_ New r Add r Alter r Demo
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Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last HARDESTY & ASSOC. INC First F—
Owner's Address
Owner's E-mail Address
711 W 17TH ST UNIT D 2
City COSTA MESA State CA
Zip 92627 Telephone
F— 4. Arch itect/Designer's Name Last
First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F_
Zip F— Telephoned
F 5. Engineer's Name Last SMART
First KAYLEEN Lic. No. 469046
Engineer's Address
„ Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH State CA
Zip 90808 Telephone 562-353-4680
F-6. Contractor's Name Last INTERFACE SYSTEMS First Lic. No. 69046 Class C10
Contractor's Address
Contractor's E-mail Address
3715D SG+I-^� /iv6. Stu It U0
City LONG BEACH State 90808
Zip CA Telephone562-353-4680
OFFICE USE ONLY
PERMIT NO.
TYPE CONSTRUCTION
OF
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $