HomeMy WebLinkAboutF2022-0168 - Permit ApplicationWorksheet for Fire Permit Appli a loo om p� �W`°
Print Form
City of Newport Beach -Building Division
Please print 3 copies 5 ^ 7 MFp0.M�A
Associated Building Permit # r" Fire Sprinkler FX_Fire Alarm F_Fire Misc 1_1>
1. Project Address (Not mailing address)
Floor
Suite No
1135 NEWPORT CENTER DR.
F
1135
Tenant Name BUCK MASON
# Units
F
Name Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
2. Description of Work
State F_ Zip F_ Telephoned
F_ 5. Engineer's Name
PROTECTED PREMISES FIRE ALARM SYSTEM
Use
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200 .
Valuation $
9000.00
Extg Sq Ft 7-New/Added Sq Ft � Total Sq Ft
Last INTERFACE SYSTEMS First Lic. No. 69046 Class C70
Contractor's Address
Contractor's E-mail Address
# Stories F
F_ New F_ Add FX_ Alter r Demo
State CA Zip 90808 Telephone562-353-4680
OFFICE USE ONLY
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name
Last IRVINE COMPANY First
Owner's Address
Owner's E-mail Address
110 Innovation Drive
City IRVINE
State CA Zip 92617 Telephone
F_ 4. Arch itect/Designer's
Name Last First Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip F_ Telephoned
F_ 5. Engineer's Name
Last SETTLEMOIR First MASON Lic. No.69046
Engineer's Address
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200 .
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
F-6. Contractor's Name
Last INTERFACE SYSTEMS First Lic. No. 69046 Class C70
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200 kelley.santacruz@interfacesys.com
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
OFFICE USE ONLY
PERMIT NO. �%0Q,2t2 • al b6
TYPE OF CONSTRUCTION K PLAN CHECK NO. �`��•���
OCCUPANCY- GROUP
xIOZ-I 33t$ PLAN CHECK FEE $