HomeMy WebLinkAboutF2022-0002 - Permit ApplicationPrint Form r:>
Worksheet for Fire Permit Application
City of Newport Beach -Building Division
Please print 3 copies
Associated Building Permit # Fire Sprinkler ri Fire Alarm C Fire Misc
1. Project Address (Not mailing address) Floor Suite No
5000 Birch St I ' 4000
Tenant Name Spec Suite 4000 j% # Units
Owner's Address
Owner's E-mail Address
2. Description of Work
_
Use B
(s—
Install (4) strobes and (3) speaker/strobes. Tie into all existing devices.
�, State CA
II—
Extg Sq Ft New/Added Sq Ft I Total Sq Ft 4245
Valuation $ 1000
Name Last Mendoza FirstGaby Lic. No.
# Stories
F_i New C Add �'i Alter ri Demol
Architect/Designer's E-mail Address
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last John Hanco_ok Real Estate
First
Owner's Address
Owner's E-mail Address
3161 Michelson Dr#410
City Irvine
�, State CA
Zip 92612 TelephoneF
L- 4. Architect/Designer's
Name Last Mendoza FirstGaby Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
1170E Fruit St
gmendoza@firesafetyfirst.com
City Santa Ana
State �A
- (
�—
Zi 92701 Tele hone 7142632871
5. Engineer's Name
Last Mendoza �i FirstGaby Lic. No.
Engineer's Address
Engineer's E-mail Address
1170 E Fruit St
gmendoza@firesafetyfirst.com
City Santa Ana
State CA
Zip 92701 Telephone7142632871
r 6. Contractor's Name
Last Fire Safety First First Lic. No.599761 Class C10/16/',
Contractor's Address
Contractor's E-mail Address
1170 E Fruit St
gmendoza@firesafetyfirst.com
city Santa Ana
State CA
Zip 92701 Telephone7148364800
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION j
t;VS✓
.- PLAN CHECK NC t 11 `L Lq
OCCUPANCY -GROUP
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PLAN CHECK FEE $
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