HomeMy WebLinkAboutX2019-1106 - Permit Application• "V11"A11CCG IVI 1711C 1-t11111L MIJtJ114,0LIVl1
City of Newport Beach - Building Division
copies 0771 -.20/Q
)(2009-0/0 00.N0.
Building Permit #
Fire Sprinkler r Fire Alarm r Fire Misc
oject Address (Not mailing address) Floor Suite No
,O Newport Center Dr 1st 150
i
i
Tenant Name West Dermatology b - SE # Units —
2. Description of Work
Fire Sprinkler TI -sprinklers Use Office
Extg Sq _—_--- Ft rNew/Added Sq Ft I--_— Total S Ft ---- Valuation $
F_ New ) Add r Alter r Demo # Stories I3
Check Appropriate Box for Applicant/Notification
1—fJormat. 0-
F 3. Owner's Name Last The Irvine Co. First ------
Owner's Address Owner's E-mail Address
101 Innovation
City Ilrvine StateCA Zip 92617
Telephoner_--
F 4. Architect/Designer's Name Last r—._ First F —
Lic. No. �'
Architect/Designer's Address Architect/Designer's E-mail Address
City r--- State F_ ZiPF-- Telephone
—
F 5. Engineer's Name Last
Engineer's Address
First
Engineer's E-mail Address
Lic. No. �—
City I State F_ZIP f ------ Telephoner----_----
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
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NO. tD \ — (9 k% C
PLAN CHECK NO. 077 k _ 7 ,r-,
PLAN CHECK FEE $
worksheet Tor etre Permit Appucatlonoc e
_Print Form
City of Newport Beach -Building Division 0711 _ goig a
Please print 3 copies Y.20)9 -J/06'
Associated Building Permit #
FX Fire Sprinkler r Fire Alarm r Fire Mlsc
1. Project Address (Not mailing address)
Floor
Suite No
680 Newport Center Dr
1st
t So
Tenant Name West Dermatology �� tjl
#Units �-
2. Description of Work
Architect/Designer's Address
Architect/Designer's E-mail Address
Use lffice
State Zip f ---- Telephoned _
Fire Sprinkler TI -P*sprinklers
97
Engineer's Address
Engineer's E-mail Address
City �
Valuation $
j- 6. Contractor's Name
Extg Sq Ft [ New/Added Sq Ft � Total Sq Ft F_
Contractor's Address
Contractor's E-mail Address
2810 E. Miraloma Ave
# Stories F
r New j— Add jX Alter r Demo
State CA Zip 92806 Telephone 714-635-6500
OFFICE USE ONLY
Check Appropriate Box for Applicantr'Notification
WWI M—N WF
F- 3. Owner's Name
Last The Irvine Co. First--_ --
Owner's Address
Owner's E-mail Address
101 innovation
city Irvine
State CA Zip 92617 Telephone)—
F- 4, Architect/Designer's Name Last First F Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip f ---- Telephoned _
F- 5. Engineer's Name
Last � First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City �
State. F_ Zip F Telephoned
j- 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 Telephone 714-635-6500
OFFICE USE ONLY
PERMIT NO. Q k
D-77 9
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
M
67'33 o3
Worksheet for Building Combo Perrrtlt Application
Co m'I Residential ?0@9 i906 City of New
Beach - Building Division �? 3 � -'LI7 �a
e)771.206A NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
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Project Address (Not lasaifing address) -/ �� �� Suite No
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Description of Work
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Use fj S ,cl�lkl
# Stories O # Units (if Res)
Valuation
Material/Labor
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ew/AddSF Remodel SF Garag--- _ _i e/New/Add
New/Add
OWNER'S NAME Last First
Owner'sI Address II // Owner's E-mail Address
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city �� --- State zip JJ i'1 TefepMoneC- ?O- 1� v
APPLVGANT'SNAME Last —� First �K ----�
Appicica itt''s Address Applicants E -mall Address
City State L r J Zip Telephone��"
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ARCFEETECTf13E5lGNER'S NAME! Last �/��/ First Lic, No. G �!/_I
Architact/Designer's Address FF Architect/Deslgnar's E-mail Addrese
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ENGINEER'S NAMES Last [ First Llc. No.�]
Engineer's Address Engineer's E -mall Address
city State Zlp—� Telephone[:7—J
GONTRACTOR'SfdAME/COMPANY % Lic. No. q7 03W J Class[
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tractor's Address �uCl �i� 1ySt��'/7 Contractors E-mail Address
City N �- -_J State �l Zlp Telephone �fJ
EWERGY PIC FEE $
GRADING P/C FEE $
ELEC/PLUM/1,AECH PIC FEE $
D F\/FI f)PMFWT #
FIRE PIC FEE $
PLANNING PIC FEE $
PERMIT NO. 'Akot ® t V U (
PLAN CHECK N0. -0-7'7 1 - _V
PLAN CHECK FEE $
TOTAL FEES PAID $ _
erlo
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st Address (Not mas@nrug address) (Air
f7 el (PlAr,
ation of Work
b
Floor Suite No
#KorlesL #Unfts(IF Res(—1
-- 'Value`-lon
New/Add SF Remodel SF ` j Ga. aga'Naw'Add Mate al/L hot
O'0(NERS NAME Lest
J. net`s Adai res
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ation of Work
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O'0(NERS NAME Lest
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Appllcrui's Addr�,s
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H RCWTFCTf6ESiGME:R e NAME
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