HomeMy WebLinkAboutF2023-0271 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Department z
Please print 3 copies
Associated Building Permit # —' -' 7 - --- Fire Sprinkler iX Fire Alarm -- Fire Misc
1. Project Address (Not mailing address)
Pacific Life
Tenant Name IPacific Life
2. Description of Work
Removal-& relocation of existing -Visual -and -audio Visual notification appliances Marked "RR" "
on the plans, installation of new visual and audio-visual notification appliances marked as "N"
on the plans. Li
Extg Sq Ft New/Added Sq Ft'. Total Sq Ff i5071
r- New --- Add ;x Alter - Demo
Check Appropriate Box for Applicant/Notification Information
Floor Suite No
I
# Units
I
Use
Valuation $ 117127
# Stories 5
3. Owner's Name Last Balfour
i First !Sarah
Owner's Address
Owner's E-mail Address
700 Newport Beach
eng5@hcisystems.net
City Newport Beach State ,CA
Zip92660 Telephonel'949-21� 9-7445
X 4, ArchitectMasigner's Name Last Ramirez
First (Gary Lic. No,'905493
Architect/Designer's Address
Architect/Designer's E-mail Address
1354 S. Parkside Pl.
eng5@hcisystems.net
City Ontario Staie CA
ZlP 91761 eiecka e 909-957-5200
5. Engineer's Name Last
First' Lic. No. i
Engineer's Address
Engineer's E-mail Address
---- ------ ------ -------...-....__- -----
City I State '�.,
---------
Zip L. Telephc:s
fx 6. Contractor's Name Last'Gomez
First'iMiriam Lic. No. 905493 Classic7c10cl6
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. 43 7
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $