HomeMy WebLinkAboutF2023-0132 - Permit ApplicationWorksheet for Fire Permit Application ;gpo�, I
City of Newport Beach - Building Department U
Please print 3 copies
Associated Building Permit # XC2022-2132 F—, Fire Sprinkler r Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1201 Dove Street, Newport Beach, CA 92660 350
Tenant Name JEIizabeth Negrete Units
2. Description of Work
Installation Or new silent Knignt power supply, Installation of new auctlTvisual notITIMUR-_ Use (:Z�
appliance, installation of new addressable duct smoke detector, installation of new control
module . . . VR
Valuation $ F
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft 4,807
Stories 6
f— New r7 Add Fx— Alter F Demo F
Check Appropriate Box for Applicant/Notification Information
f7; 3. Owner's Name
Last Duchateau
First Jeffery P.
Owner's Address
Owners E-mail Address
041 MaCarthur Blvd Suite
250
liduchateau@ipc.com
City Newport 11 Bea , ch
State PA
Zip 92660 Telephone F(949)333-21 11
4. Architect/Designer's
Name Last lGary
First [Ramirez Lic. No. 9054977
F
Architect/Designer's Address
Architect/Designers E-mail Address
1354 S. Parkside PI.
eng5@hcisystems.net
J
City Ontario 1 I I
State CA
Zip 91761 Telephone �-r�-�200 ..
rl 5. Engineer's Name
Last
First F Lic. No. F
Engineer's Address
Engineers E-mail Address
State
Zip Telephone
F
6. Contractor's Name
Last Gomez First Miriam Lic. No. [905493 Class F000c`16
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside Pl.
En95@hcisystems.net
City jOntario
State PA
Zip [91176 F9
Telephone-957-5200
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. GCZC_?�
OCCUPANCY- GROUP
PLAN CHECK FEE $