HomeMy WebLinkAboutF2021-0053 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3copies V20Z1 -0053
Associated Building Permit # Q Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
CA 1st 125
991 MacArthur Blvd., Newport Beach,
Republic Bank # Units
Tenant Name First
2. Description of Work
City �—
Use
Relocation of 22 fire sprinklers for a new TI work
F— 4. Architect/Designer's Name Last First F Lic. No.
Valuation $ 3,200.00
Extg Sq Ft F0 New/Added Sq Ft �— Total Sq Ft F300
Architect0esigner's E-mail Address
# Stories F
F- New r Add Q Alter r Demo
Check Appropriate Box for Applicant/Notification
F- 3. Owner's Name
Last FirstF
Owner's Address
Owner's E-mail Address
City �—
State �� Zip Telephone
F— 4. Architect/Designer's Name Last First F Lic. No.
Architect/Designer's Address
Architect0esigner's E-mail Address
City
State Zip F TelephoneF—
{—' 5. Engineer's Name
Last First— Lic No.�
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F Telephoned
VZ6. Contractor's Name
Last Garibian First iggen Lic. No. 603205 Class C-16
Contractor's Address
Contractor's E-mail Address di" 0eecl-S zrs. lacy,)`
3457 Ocean View Blvd.
iggen@axisfp.com
Cell# $18-Z
9419Ej
City Glendale
State CA Zip 1208 TelephoneF8-546-294781
OFFICE USE ONLY
PERMIT NO. _L02+1
TYPE OF CONSTRUCTION — PLAN CHECK NO.
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OCCUPANCY - GROUPS
PLAN CHECK FEE $