HomeMy WebLinkAboutF2024-0154 - Permit Application2
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City of Newport Beach Fire Permit Application
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Project Address I��JN1��R-�f c-cTl%e�r— Dp— Sulam F
Number and Street sui a/unit zip
Associated Building Permit #
Owner /Tenant Name /q—, V r" (ph o,-e
J o V
Scope ofwork/ �� 1 1 tp t l "► t nisc. description 9�j S-Tt-'/ l
construction TI Addition Alteration Demolition
'Check one
Commercial Fire Sprinkler
P13 13R 13D
aMulti -Family (3+units) Fire Alarm
aResidential (1-2 units) Fire Underground
'Checkone Fire Misc.
*describe above
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Number of Stories
Number of Heads per building
03 Vumber of Devices El Number of
Dwelling Units
Number of Risers
'Write in accurate count
4 Applicant Information
Name: Kelley Santa Cruz
Address:
Phone#: Email:
kelley.santacruz interfacesys.com
heck if same as Contractor
Designer Information
Name:
Address:
Phone#: Email:
Q Check if same as Contractor
Contractor Information
Name: Interface Systems
Address: 3797 SC�t�CuL{2�C fNt
SA, fe 7iD0
Phone#: ShZ 3& 3C% 0D Email:
kelley.santacruz interfacesys.com
License#: 41t, q n t,lk Class:
0 In
Office Use
Permit F2o2V „6 Uq Plan Check Permit /Plan
Number Number (Y� Check Fee $