HomeMy WebLinkAboutF2021-0056 - Permit ApplicationWorksheet for Fire Permit Application
Irmt FtlirST;r:-; City of Newport Beach - Building Department
Please print 3 copies
Associated Building Permit # X2020-0923 r Fire Sprinkler r; Fire Alarm r—, Fire Misc
1. Project Address (Not mailing address) Floor Suite No
4000 MacArthur Boulevard, Newport Beach, CA 92660 2nd
Tenant Name Macom 2nd Floor KoII Center #Units F
2. Description of Work
Owner's E-mail Address
Use B -office
Installation of speaker strobes, strobes and control relay.
(Total 13 devices) i {
City Newport Beach State
Extg Sq Ft New/Added Sq Ft Total Sq Ft 1,571
1
Valuation $ 5 621.50
4. Architect/Designer's Name Last Mapte�
r' g I y
# Stories F10
F— New ri Add r, Alter F Demo
Check Appropriate Box for Applicant/Notification Information
3. Owner's Name Last Higuchi
First Amy
Owner's Address
Owner's E-mail Address
4000 MacArthur Boulevard
City Newport Beach State
CA
Zip 92660 Telephone(949)313-2212
4. Architect/Designer's Name Last Mapte�
r' g I y
First Joseph Lic. No.
i P„
Architect/Designer's Address
Architect/Designer's E-mail Address
1354 S. Parkside PI.
eng3@hcisystems.net
City Ontario State CA
Zip 91761 Telephone(909)957-5200
F—, 5. Engineer's Name Last
FirstLic. No.
Engineer's Address
Engineer's E-mail Address
City State
Zip F�. Telephoned
n 6. Contractor's Name Last HCI Systems Inc
FirstLic No. 905493 Glass c7c10c16
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside PL
Eng5@hcisystems.net
City Ontario State
CA
Zip 91761 Telephone909-957-5200
OFFICE USE ONLY
• �I CJD PERMIT NO. 'f/to r ov<; Le
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TYPE OF CONSTRUCTION
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Q�'I/J PLAN CHECK NO. �%�✓��' ���
OCCUPANCY - GROUP
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a. PLAN CHECK FEE $