HomeMy WebLinkAboutF2022-0208 - Permit ApplicationWorksheet for Fire Permit Application �W_poV,
Rr irat Form.. City of Newport Beach - Building Department
Please print 3 copies LS03 202 i rj ZDZ�j D20
Associated Building Permit # IF—RLt�Zi , Gg��( r, Fire Sprinkler jjr Fie Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
840 Newport Center Drive, Newport Beach, CA 92660 2-3 Po_
Tenant Name The Irvine Company # Units
2. Description of Work
Replace existing
Extg Sq Ft 1,339 j New/Added Sq Ft � Total Sq Ft F-----•�,
r New �I Add T: Alter r Demo
Use
Valuation $ 711.25
# Stories
Check Appropriate Box for Applicant/Notification Information
3. Owner's Name Last Merrill First Catelyn „
Owner's Address Owner's E-mail Address
111 Innovation
City Irvine State CA Zip 92617 Telephone (949)720-4308
rj—r, 4. Architect/Designer's Name Last Brion First Jerome Lic No.
__
Architect/Designer's Address Architect/Designer's E-mail Address
1354 S. Parkside PI.
City Ontario State CA„ Zip 91761 Telephone (909)957-5200„
r 5. Engineer's Name Last First F777777 Lic No.
Engineer's Address Engineer's E-mail Address
city State r Zip �— Telephoned
Ix16. Contractor's Name Last Dominique First Williams Lic. No. 905493 Class c7c10c16
Contractor's Address Contractor's E-mail Address
1354 S. Parkside PI. Eng5@hcisystems.net
City Ontario State CA Zip 91761 Telephone 909-957-5200
OFFICE USE ONLY PERMIT NO. 1L"11
TYPE OF CONSTRUCTION PLAN CHECK NO. I V 6 1 •`Lf7?'?'
OCCUPANCY - GROUP S ( ; PLAN CHECK FEE $