HomeMy WebLinkAboutF2023-0234 - Permit ApplicationPrnrFrm: Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # 2021-3309 Fire Sprinkler XX_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
20350 Birch St Newport Beach CA 92660
Tenant Name UCI HEALTH
2. Description of Work
Convert Clinic &Staff Lounge ;voe-Grre M
Extg Sq Ft k233 New/Added Sq Ft F Total Sq Ft—,_
f7 New Add r Alter Demo
Check Appropriate Box for ApplicanVNotifi cation
Floor Suite No
2nd 02
# Units F
Use Medical
Valuatino
# Stories 12
Xi 3. Owner's Name Last Lee
�', First IDavid
Owner's Address
Owner's E-mail Address
0350 SW Birch St
lee@calcomm.org
City Newport Beach
State CA Zip 2660 Telephone 949-381-7408
i! 4. Architect/Designer's Name Last
�— First I Lic. No.
IIII
Architect/Designer's Address
Architect/Designer's E-mail Address
City -_
State �Zip �— Telephone
[X! 5. Engineer's Name Last itzigman FirstFhael Lic. No. E13442
Engineer's Address
Engineer's E-mail Address
825 Reaserch Drive
iggy.witzigman@salasobrien.com
City Irvine
State CA Zip 2618 Telephone 49-753-1553
rXi 6. Contractor's Name Last Cupsa _ - First Mike __.. _.., _ Lic No. 847803 Class F0_. (�•
Contractor's Address
Contractors E-mail Address r jp 2-
611 N Poplar St
ikec@protek-electric.com
City Orange
State CA Zip 2868 Telephone 14-240-7123
OFFICE USE ONLY
PERMIT NO. F—�,20Zi 7 —o
TYPE OF CONSTRUCTION
PLAN CHECK N0.1 f%2-2f/; -1 _1 7
OCCUPANCY - GROUP
�2l
U PLAN CHECK FEE $