HomeMy WebLinkAboutF2019-0364 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Nol
13300 Irvine Ave
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
mailing address)
Tenant Name 1Coury & Buehler Physical Therapy
2. Description of Work
Fire Sprinkler r Fire Alarm r Fire Misc
20 upright sprinkler heads, relocate 6 pendent sprinkler heads & install 1 new penaem
er head
Extg Sq Ft 1363— New/Added Sq Ft Total Sq Ft
New F— Add (X Alter Demo
Check Appropriate Box for Applicant/Notification
L.F...m�4inn.
Floor Suite No
1st — 130
# Units
Use B -Medical
valuation $ 4725
# Stories F3
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First I
MI
F- 3. Owner's Name Last
Owner's Address
— _ __-
owner's E-mail Address -
�-" -
City I
State F
Zip �— Telephone[--
4. Architect/Designer's Name Last MSA Inc
First �— Lic. No.
Arch itect/Designer'sAddress
Architect/Designer's E-mail Address
mschafer@msa-corp.net
L3112 Alcade Dr Suite B
Hills
State �ca
Zip 92653 Telephone 949-584-5426
City Laguna
Last
Firstr__Lic. No.
1-- 5. Engineer's Name
Engineer's Address
Engineer's E-mail Address
(City
State �—
Zip �_ TelephoneF�
w Lic. No. 949924
Class C-16
IX 6. Contractor's Name Last Rising[Troy
First
Contractor's Address
Contractor's E-mail Address
_
13217 Jamboree Rd #464
troy@optimumfireprotection.com
City Tustin
State CA
Zip 92782 - Telephone �714-71�_
OFFICE USE ONLY
PERMIT N0. '
TYPE OF CONSTRUCTION
fo
• PLAN CHECK NO.
OCCUPANCY - GROUP
i
i a • PLAN CHECK FEE $
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