HomeMy WebLinkAboutF2019-0304 - Permit ApplicationWorksheet for Fire Permit Application o�EW�gm
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # F Fire Sprinkler rxFireAlarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
F 363
363 NEWPORT CENTER DRIVE
F.I. SUITE 363 LANDLORD DEVELOPMENT T.I. # Units
Tenant Name
2. Description of Work
State NY Zip 10016 Telephone 12-545-0500
PROTECTED PREMISES FIRE ALARM SYSTEM .
Use
Architect/Designer's Address
Architect/Designer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
Valuation $ 4,500.00
Extg Sq Ft 7—New/Added Sq Ft � Total Sq Ft
State CA Zip 90808 Telephone562-353-4680
F_ 5. Engineer's Name Last
# Stories
F_New F_Add r Alter F_Demo
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
F_ 3.Owner's Name Last JRM CONSTRUCTION MGMNT First LLC
Owner's Address
Owner's E-mail Address
242 WEST 36TH ST 9TH FLOOR
City NEW YORK
State NY Zip 10016 Telephone 12-545-0500
F_ 4. Arch itect/Designer's Name
Last PETTY First PAUL Lic. No. 469046
Architect/Designer's Address
Architect/Designer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
PAUL.PETTY@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
F_ 5. Engineer's Name Last
First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip F—TelephoneF
F
6. Contractor's Name Last INTERFACE SYSTEMS First �— Lic. No. 69046 Class C10
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200
KELLEY.SANTACRUZ@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone 562-353-44680
OFFICE USE ONLY
TYPE OF CONSTRUCTION
` j PERMIT NO. okp ileI
✓ I/V �'"" l . PLAN CHECK NO
OCCUPANCY - GROUP
PLAN CHECK FEE $
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