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Associated Building Permit#
Worksheet for Fire Permit Application
City of Newport Beach - Building Division .230q,O19
F',201q-0573
F— Fire Sprinkler r Fire Alarm r— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
953,941 NEWPORTCENTER DRIVE �— 953,941
Tenant Name FASHION ISLAND -SUITES 953&941 VANILLA BOX # Units F
2. Description of Work
Owner's E-mail Address
1442 E LINCOLN AVE #334
Use
PROTECTED PREMISES FIRE ALARM SYSTEM
;rev t�5
lll-C3-s,, 1Z
Zip 92660 TelephoneF—
Valuation $ 5600.00
Extg Sq Ft F New/Added Sq Ft F_Total Sq Ft F_
Architect/Designer's Address
r New j— Add F_ Alterr Demo
# Stories F
3750 SCHAUFELE AVE
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last KDC CONSTRUCTION
First
Owner's Address
Owner's E-mail Address
1442 E LINCOLN AVE #334
City ORANGE
State CA
Zip 92660 TelephoneF—
F_ 4. Architect/Designees Name
Last PETTY First PAUL Lic. No.69046
Architect/Designer's Address
Arch itect/Designer's E-mail Address
3750 SCHAUFELE AVE
PAUL.PETTY@INTERFACESYS.COM
city LONG BEACH
State CA
Zip 90808 Telephone F562-353-4680
r 5. Engineer's Name Last
First F_Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_—
Zip F— TelephoneF—
F- 6. Contractor's Name Last INTERFACE SYSTEMS First F Lic. No. 69046 Class C10
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE
KELLEY.SANTACRUZ@INTERFACESYS.COM
City LONG BEACH
State CA
Zip 90808 Telephone 562-33553-46801
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $