HomeMy WebLinkAboutF2021-0129 - Permit ApplicationY Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # R Fire Sprinkler r-. Fire Alarm
r Fire Misc
'i. Protect Addroa. /ra..L
o203b'/ .5 ri islieW siLr�-
Tenant Name I A"NLnAAnt,, IMS-rllr4Cr6�
2. Description of Work
Exig Sq Ft�— New/Added Sq Ft F� Total Sq Ft �—
r New r Add OZ Alter I— Demo
Check Appropriate Box for ApplicanMotification
Use
70
Floor
—r Suite No
—
# Units
Valuation
# Stories
j' 3.Owner's Name Last I —
First --
Owner's Address
Owners E-mail Address
City State F-
ZAP [' Telephone--
i— 4. Architect/Designer's Name Last
First—, Ltc.No.
Architect/Designer's Address --
Architect/Designees E-mail Address
City State Zip �— Telephoned—'
r 5. Engineer's Name Last First
Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City - State �—
ZIP �— TelepheneF—
OZ 6. Contractor's Name LastPEX FIRE SYSTEMS
First F — Lic, No. 732396 Class -16
Contractor s Address
961 WEST MACARTHUR BLVD
City FANTA ANA State FA —
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Contractor's E-mail Address
arc@apexfiresys.com
Zip F2704 Telephone 49-337-9679
PERMIT NO. j'i'v=VI
PLAN CHECK NO. _i 161,
�G�Gl PLAN CHECK FEE $
i