HomeMy WebLinkAboutF2021-0119 - Permit ApplicationWorksheet for Fire Permit Application
Ivor, orrr City of Newport Beach - Building Division _ ,
Please print 3copies f ZUZ's
Associated Building Permit #
R Fire Sprinkler r Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
/'riZmR
,S'000 %jIRC�F S'IREeT'
%Ni #Units
Tenant Name 7rr,�s
2. Description of Work
Owner's Address'
use 7/ TirkiSSS
21 FOe6 XfAIWAC6/LS P6;e- -r-X-
Valuation $ F,2-
-
Extg Sq Ft F New/Added Sq Ft F Total Sq Ft
Zip F—...Telephone[—
# Stories F
r, New F"', Add PZ, Alter r Demo
First F_ Lic. No.
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
First
Owner's Address'
Owner's E-mail Address
City _.. _. _State
F—,
Zip F—...Telephone[—
F- 4. Architect/Designer's Name Last
F
First F_ Lic. No.
F
Architect/Designer'sAddress
Architect/Designers E-mail Address
City
State —.
Zip F Telephoned—
5. Engineer's Name Last WAf) First �}12� Lic No.
737316
Engineer's Address
Engineer's E-mail Address
2q6 f
«-t
/Vd .. At_..
city
City 3(L� V'�`
State r !,
41
Zip 9'Z7D�{ Telephone 111
R 6. Contractor's Name Last PEX FIRE SYSTEMS First �— Lic. No. 732396 Glass C-16
Contractor's Address
Contractor's E-mail Address
961 WEST MACARTHUR BLVD
marc@apexfiresys.com
City SANTA ANA
State CA
Zip 92704 Telephone 949-337-9679
OFFICE USE ONLYdi
�NNA
PERMIT NO. rr� • D L
TYPE OF CONSTRUCTION
PLAN CHECK NO-
O.OCCUPANCY-
OCCUPANCY-GROUP
to
PLAN CHECK FEE $