HomeMy WebLinkAboutF2020-0137 - Permit ApplicationWorksheet for Fire Permit Application � U I
Print Form
— -- - City of Newport Beach -Building Division
Please print 3 copies boa r
Associated Building Permit # r Fire Sprinkler (x Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
957 NEWPORT CENTER DRIVE
F__
957
Tenant Name F.I. - SUITE 957 COREPOWER YOGA
# Units
�-
2. Description of Work
Architect/Designer's Address
Architect7Designer's E-mail Address
3750 SCHAUFELE AVE SUITE
Use
City LONG BEACH
PROTECTED PREMISES FIRE ALARM SYSTEM
[— 5. Engineer's Name
Last First F— Lic. No.
Engineer's Address
Valuation $
$4,500.00
Extg Sq Ft 7— New/Added Sq Ft F_Total Sq Ft �—
F 6. Contractor's Name
Last INTERFACE SYSTEMS First Lic. No. 469046 Class C10
Contractor's Address
# Stories F
I— New r Add r Alter F— Demo
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
Check Appropriate Box for Applicant/Notification
Ir.i...w.�4'..n
F_ 3. Owner's Name
Last Horizon Retail Construction Inc First
Owner's Address
Owner's E-mail Address
9999 E. Exploration Ct.
City Sturtevant
State WI Zip 53177 Telephone
F_ 4. Architect/Designer's
Name Last PETTY First PAUL Lic. No. 469046
Architect/Designer's Address
Architect7Designer's E-mail Address
3750 SCHAUFELE AVE SUITE
200 PAUL.PETTY@INTERFACESYS.COM
City LONG BEACH
State CA Zip 90808 Telephone
[— 5. Engineer's Name
Last First F— Lic. No.
Engineer's Address
Engineer's E-mail Address
City I
State F— Zip F— Telephoned
F 6. Contractor's Name
Last INTERFACE SYSTEMS First Lic. No. 469046 Class C10
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. w��Ut
,
TYPE OF CONSTRUCTION PLAN CHECK NO. �✓�yd-CLtLv
OCCUPANCY - GROUP
a PLAN CHECK FEE $
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