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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division Z2 TO A019 0
f 20/9..0551
r Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
�— 953
953 NEWPORT CENTER DRIVE NEWPORT BEACH, CA 92660„
# Units �-
Tenant Name FASHION ISLAND SUITE 953 VANILLA BOX T.I.
2. Description of Work
Owner's E-mail Address
UseFU -
PROTECTED PREMISES FIRE ALARM SYSTEM
1Sq
Valuation$ 15,450.00
Extg Sq Ft INew/Added Sq Ft Tot't
3750 SCHAUFELE AVE
PAUL.PETTY@INTERFACESYS.COM
# Stories
r New r Add r Alter r Demo
F- 5. Engineer's Name
Check Appropriate Box for Applicant/Notification
Y - GROUP PLAN CHECK FEE $
3. Owner's Name
Last KDC CONSTRUCTION First F—
Owner's Address
Owner's E-mail Address
1442 E. LINCOLN AVE #334
City ORANGE State CA Zip 92660 Telephone—
j- 4. Architect/Designer's Name Last PETTY First PAUL Lic. No. 69046
Architect/Designer's Address
Architect/Designer's E-mail Address
3750 SCHAUFELE AVE
PAUL.PETTY@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone 562-353-4680
F- 5. Engineer's Name
Last First 7 Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State-: Zip F Telephone—
- 6. Contractor's Name
Last INTERFACE SYSTEMS First Lic No. 69046 Class C10
'ntractor's Address
Contractor's E-mail Address
SCHAUFELE AVE
KELLEY.SANTACRUZ@INTERFACESYS.COM
'-)NG BEACH
State CA Zip 90808 Telephone 562-353-4680
SE ONLYa�
`ONSTRUCTION
� PERMIT NO.
2 1 .- NO.
PLAN CHECK
Y - GROUP PLAN CHECK FEE $