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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1, Project Address (Not mailing address)
40 BEACON WAY
Tenant Name
-
i _ Fire Sprinkler (XFire Alarm r— Fire Misc
Floor Suite No
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# Units F—
2. Description of Work
INSTALL A NEW SPRINKLER MONITORING SYSTEM. Jr+xR Use
Valuation$ 16,188.00�
Extg Sq Ft F— New/Added Sq Ft F_- Total Sq Ft —_ �
f? New Add [- Alter r Demo #Stories
t,necK Appropriate rsox Tor AppiicanVNotification
f- 3.Owner's Name Last-
First - -- _—''
Owner's Address
- -
Owners E-mail Address
City
State r
Zip r Telephoner
(- 4. ArchitectlDesigner's Name
Last ESPINOZA
First STEVEN Lic. No.
Architect/Designer's Address
2705 MEDIA CENTER DRIVE
Architect/Designer's E-mail Address
STEVENSPINOZA@ADT.COM
City LOS ANGELES
State CA
Zip F90065 Telephone 323-276-3123
(- 5. Engineer's Name Last
FirstF_—V"� Lic No.
Engineer's Address
Engineer's E-mail Address
City �..__..�.
State F_.
Zip r— Telephoned.--- k
F 6. Contractor's Name Last ADTCOMMERCIAL
FirstF � Lic. No. [I 065604 Class C10-C16
Contractor's Address
Contractor's E-mail Address
210 W. BAYWOOD AVE.
SEYEDAHRAR@ADT.COM
City Orange
State [CA
Zip 92765 Telephone 714-685 8133
FICE USE ONLY
PERMIT NO. Tc %Ot ' O 1'&%(#
TYPE OF CONSTRUCTION
w�1
PLAN CHECK NOyU1Zti
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OCCUPANCY -GROUP
PLAN CHECK FEE $ i i
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