HomeMy WebLinkAboutF2021-0222 - Permit Application�7A71 'U1-?iY
Worksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Oct11
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Associated Building Permit #
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Fire Sprinkler
�YFFiirte Alarm
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r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
—
F_
NEWPORT CENTER DRIVE I 579
Tenant Name FASHION ISLAND LANDLORD DEV. 579 # Units F
2. Description of Work
City IRVINE
State CA Zip 92618 TelephoneF—
Use
\10,000.00
PROTECTED PREMISES FIRE ALARM SYSTEM
Extg Sq Ft � New/Added Sq Ft F Total Sq Ft �—
Valuation $
F_ New i— Add Fx Alter#
(— Demo
Stories
(3
P2
City LONG BEACH
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Check Appropriate Box for Applicant/Notification
InF.. ..F:..
F_ 3. Owner's Name Last BOGART CONSTRUCTION First r
Owner's Address
Owners E-mail Address
9980 IRVINE CENTER DRIVE SUITE 200
City IRVINE
State CA Zip 92618 TelephoneF—
F_ 4. Arch itect/Designer's Name
Last PETTY First Paul Lic. No. 469046
Architect/Designer's Address
Architect/Designers E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
r 5. Engineer's Name Last
First F_ Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City
State 7— Zip 7— Telephone
6. Contractor's Name Last INTERFACE SYSTEMS First Lic. No. 69046 Class C, 0
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200
kelley.santacruz@interfacesys.com
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. 127
OCCUPANCY - GROUP
Z��� _ U�1( PLAN CHECK FEE $