HomeMy WebLinkAboutF2023-0267 - Permit ApplicationWorksheet for Fire Permit Application (Fdi494Rr?
City of Newport Beach - Building Department Please print 3 copies �V%&q: xczpz. —60gA
Associated Building Permit # Z' — r Fire Sprinkler x Fire Alarm i— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Pacific Life
Tenant Name iPacific Life
2. Description of Work
the plans, installation of new visual and audio-visual notification appliances marked as "N"
the Dlans.
Extg Sq Ft 1 ` New/Added Sq Ft F Total Sq Ft 5071
r— New j— Add x Alter I` Demo
Check Appropriate Box for Applicant/Notification Information
# Units
Use
Valuation $ 7127
# Stories I5
r 3. Owner`s Name Last Balfour
First iSarah
Owner's Address
Owner's E-mail Address
700 Newport Beach
eng5@hcisystems.net
City Newport Beach State `CA
Zip 92660 Talephonel949-219-7445
Fx 4. Architect/Designer's Name Last (Ramirez
First Gary Lic, No. 905493
Architect/Designer's Address
ArchitectIDesigner's E-mail Address
1354 S. Parkside PI.
ieng5@hcisystems.net
City Ontario State CA
Zip 191761 J Telephone 909-957-5200
F-" 5, Engineer's Name Last v First I — Lic No.
Engineer's Address
Engineer's E-mail Address
)
City I State i u
Zip Telephoner
IT 6. Contractor's Name Last Gomez
First (Miriam Lic. No. 905493 Class�c7c10c16
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside PI.
JEng5@hcisystems.net
City !Ontario State 1CA
Zip i91761 Telephone .90 957-5200
OFFICE USE ONLY
PERMIT NO. f WO OZ6 7
TYPE OF CONSTRUCTION _
PLAN CHECK NO. K_ W13-13�`I
OCCUPANCY - GROUP
PLAN CHECK FEE $