HomeMy WebLinkAboutF2023-0268 - Permit Application0 Worksheet for Fire Permit Application
Print Form City of Newport Beach - Building Department
Please print 3 copies
Associated Building Permit # ' XCX z3_ O 1 (eF5 Fire Sprinkler (x Fire Alarm Fire Misc
' v
1. Project Address (Not mailing address)
Pacific Life
Tenant Name IPacific Life
2. Description of Work
79111 V6VWWfflUcWflon ot exis i n g vIsua I an audw-visu7 n- tifi can o n a p p iances ma-rR-e- "RR" —
ion the plans, installation of new visual and audio-visual notification appliances marked as "N"
on the Dlans.
Extg Sq Ft F New/Added Sq Ft I Total Sq Ft 5071
(— New I— Add ix Alter r Demo
Check Appropriate Box for Applicant/Notification Information
Floor Suite No
1 z-;: F—
# Units I —
Use i
Valuation S 7127
# Stories IS
j' 3. Owner's Name Last Balfour
First Fsarah
Owner's Address
Owner's E-mail Address
I700 Newport Beach
eng5@hcisystems.net
City Newport Beach State
CA
Zip i9266� 0 Telephonel949-219-7445
F)f 4, ArchitectlDesigner's Name Last !Ramirez
First Gary Lic. No. 905493
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
1354 S. Parkside PI.
eng5@hcisystems.net
City Ontario State
1CA
Zip 191761 Telephone 909-957-5200
5. Engineer's Name Last First �_ Lic. No. F
Engineer's Address
Engineer's E-mail Address
City State
F—
Zip F` Telephoner
r 6. Contractor's Name Last Gomez
First !Miriam Lic. No. 905493 Classlc7c10c16
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside PI.
Eng5@hcisystems.net
City ;Ontario State
ICA
Zip .91761 Telephone;909-957-5200
OFFICE USE ONLY
PERMIT NO. F2oZ3 - p26$
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $