HomeMy WebLinkAboutF2021-0082 - Permit ApplicationPrint Form worasneet Tor r'Ire rermn ,ypp ication Please print 3 copies o�` m
City of Newport Beach - Building Division �i� L (, 0Z' 6 ` '�
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Associated Building Permit# FX_ Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
330 Old Newport Blvd _ 1-2 F_
Tenant Name r
JUSC Keck Medical # Units
2. Description of Work
Install (156) pendent sprinkler heads & (5) upright sprinkler heads. Use Medical
Extg Sq Ft 24500 New/Added Sq Ft Total Sq Ft Valuation $ 33,500 --
F_ New F Add F>_� Alter F_ Demo # Stories �2
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
First
Owner's Address Owner's E-mail Address
City ... -_-. State �—. Zip— Telephone
r 4. Architect/Designer's Name Last First F_ Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City _.. _ State �- Zip �Telephoned—
r 5. Engineer's Name Last First F�-
Lic No.
Engineer's Address Engineer's E-mail Address
City State [_ Zip �— Telephone _
6. Contractor's Name Last Optimum Fire Protection First
Contractor's Address
13217 Jamboree Rd #464
City Tustin _ _ State CA
Lic No. 9499 44 Class C16
Contractor's E-mail Address
trOY@OptiMumfireprotectiop.com
Zip 82 Zl$Z Telepho `e 27127393 . -
OFFICE USE ONLY i1I)/J�„ A PERMIT NO. q TYPE OF CONSTRUCTION PLAN CHECK NO. l
OCCUPANCY- GROUP
PLAN CHECK FEE $
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