HomeMy WebLinkAboutF2021-0511 - Permit Application004-,�
Worksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies oezz
Ix— Fire Sprinkler r Fire Alarm r Fire Misc
Associated Building Permit # 1749-2021. r
Floor Suite No
1. Project Address (Not mailing address) 1St.
2161 San Joaquin Road
#Units
Tenant Name UCI Executive Health
2. Description of Work
Sprinkler System Tenant Improvement. (Add/Relocate 8 Heads)
Extg Sq Ft F— New/Added Sq Ft F Total Sq Ft
r New r Add rAlter r Demo
Check Appropriate Box for ApplicantlNotification
r 3. Owner's Name Last
Owner's Address GLS f 7�
�—
Owner's E-mail Address
Use Office
`13- 15
Valuation $ 3,250.00
# Stories I
City
'. State F_ Zip F Telephone—
FX_
4. Architect/Designees Name Last [Chavez
First Eric Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
1075 W. Lambert Road
fmone@coscofire.com
State Ca
Zip 92821 Telephone 714-989-1800
City
Brea
First F- Lic. No.
F- 5. Engineer's Name
Last
Engineer's Address
Engineer's E-mail Address
State I—'
Zip F_' Telephone—'
City
' First
F� Lic. No. 577621 ClassC-16
F- 8. Contractor's Name
LastCosco
Fire Protection Inc
Contractor's Address
Contractor's E-mail Address
1075 W. Lambert Road
fmone@coscofire.com
State Ca.
Zip 92821 Telephone 714-989-1755
City
Brea
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NO.��� ^ Q
PLAN CHECK NO. 1
PLAN CHECK FEE $