HomeMy WebLinkAboutF2022-0569 - Permit ApplicationWorksheet for Fire Permit Application �C2o22�� 04�'�Hm
Please print 3 copies
City of Newport Beach - Building Department .'
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Associated Building Permit # XC2022-1995 Fire Sprinkler rxt Fire Alarm j Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1301 Dove Street Newport Beach, CA 92660I F_ 820
Tenant Name Strunk Loos Family Law # Units F_
2. Description of Work
Removal and relocation of exiting visual and audio-visual notification Z Use
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Extg Sq Ft 4748 New/Added Sq Ft Total Sq Ft Valuation $F�
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F- New I` Add Fx- Alter Demo # Stories Flo
Check Appropriate Box for Applicant/Notification Information
F 3. Owner's Name Last (Torre
First Carman
Owner's Address Owner's E-mail Address
1301 Dove Street Suite 550
City Newport Beach State CA Zip 92660 Telephone 9492528844
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rx— 4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address -
Architect/Desi ner's E-mail Address
1354 S. Parkside PI.
_. City Ontario State CA Zip 91761 Telephone 909-957-5200
5. Engineer's Name Last FirstF—
Lic. No.
Engineer's Address -
Engineer's E-mail Address
City State F— Zip Telephone
FT 6. Contractor's Name Last Williams First Dominique Lic No. 905493 Class c7c10c16
Contractor's Address Contractor's E-mail Address
1354 S. Parkside PI. Eng5@hcisystems.net
City OntarioZip 91761 Telephone 909-957-5200
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION V ` PLAN CHECK NO.1�iZa��/• l� ��(
OCCUPANCY -GROUP /�/_� •�
`V PLAN CHECK FEE/ $