HomeMy WebLinkAboutF2019-0352 - Permit ApplicationPnntForm_j Worksheet for Fire Permit Application
City of N�VewA,po1rt Beach`�- Building Division
Please print 3 copies I v V l,q — �) 52
Associated Building Permit#
/ " T
F— Fire Sprinkler r Fire Alarm r Fire Misc
QVWM",
1. Project Address (Not mailing address) Floor Suite No
1370 BISON AVE.
_
Tenant Name ITHE BLUFFS SHOPPING CENTER 4 �-
2. Description of Work
PO BOX 2460
FIRE SPRINKLER MONITORING SYSTEM 5
Use
State CA Zip 92658 Telephone—
r 4. Arch itect/Designer's
vvValuation
Extg Sq Ft �— New/Added Sq Ft F Total Sq Ft
$ 8,000
Architect/Designer's E-mail Address
# Stories F
F_ New r Add j— Alter F_ Demo
City LONG BEACH
Check Appropriate Box for Applicant/Notification
I— 3. Owner's Name
Last IRVINE CO. RETAIL PROP. First
Owner's Address
Owner's E-mail Address
PO BOX 2460
City NEWPORT BEACH
State CA Zip 92658 Telephone—
r 4. Arch itect/Designer's
Name Last SMART First KAYLEEN Lic. No. 469046
Architect/Designees Address
Architect/Designer's E-mail Address
3750 SCHAUFELE AVE
KAYLEEN.SMART@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
F_ 5. Engineer's Name
Last FirstF Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State 7— Zip F Telephoned
F- 6. Contractor's Name
Last INTERFACE SYSTEMS First Lic. No. 69046 Class clo
Contractor's Address
Contractor's E-mail Address
750 SCHAUFELE AVE
KELLEY.SANTACRUZ@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
OFFICE USE ONLY
PERMIT NO. zo
�y�5
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $