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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
F202(-05q?C1
Fire Sprinkler r` Fire Alarm r Fire Misc
U06
1. Project Address (Not mailing address) leof Suite No
4000 MacArthur Blvd 9F 900
Tenant Name 4000 MacArthur 9th/10th # Units 1
2. Description ork
30 Hudson Street
AMY.HIGUCHI@HINES.COM
Use Once
Fire Sprinkler T A -- sprinkle
Preaction sprinkler syste -y
2 s rinklers
Name Last First Lic. No. F
Extg Sq Ft I� New/Added Sq Ft F—Total Sq Ft �—
Valuation $ 7,000
City �
Stories 10
New r Add#
r Alter r' Demo
Last First F, Lic. No.
Check Appropriate Box for Applicant/Notification
Inf~rm Nnn
F_ 3. Owner's Name
Last Hines First
Owner's Address
Owner's E-mail Address
30 Hudson Street
AMY.HIGUCHI@HINES.COM
City Jersey City
State NJ Zip 07302 Telephone (949) 313-2212
F_ 4. Architect/Designer's
Name Last First Lic. No. F
Architect/Designees Address
Architect/Designer's E-mail Address
City �
State F_ Zip Telephone—
r 5. Engineer's Name
Last First F, Lic. No.
Engineer's Address
Engineer's E-mail Address
City �—�
State Fi Zip F Telephone
F_ 6. Contractor's Name
Last Fire Protection Specialists, Inc First Robert Anderson Lic. No. 464915 Class C-16
Contractor's Address
Contractor's E-mail Address
2810 E. Miraloma Ave
robert@fireprotectionspecialists.com
City Anaheim
State CA Zip 92806 Telephone714-635-6500
OFFICE USE ONLY
✓ ��`PERMIT NO.
TYPE OF CONSTRUCTION Q) &) PLAN CHECK NO.
(1
OCCUPANCY -GROUP
C PLAN CHECK FEE $