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Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
F Fire Sprinkler lX Fire Alarm
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f— Fire Misc
1. Project Address (Not mailing address)
CONSTRUCTION First �—
Floor Suite No
363 NEWPORT CENTER DRIVE
Owner's E-mail Address
�— 363
Tenant Name OFFLINE BY AERIES - Fashion Island Suite 363
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# Units
2. Description of Work
State CA Zip 91786 Telephone—
PROTECTED PREMISES FIRE ALARM SYSTEM �� 1'V I�
y �I d
Use
Extg Sq Ft F— New/Added Sq Ft �— Total
Sq Ft
Valuation $ $8,000
City _ -
State Zip F- Telephone
---
F_ New F_ Add F Alter F Demo
RENKIN
# Stories F
Check Appropriate Box for Applicant/Notification
F 3. Owner's Name Last ITIMBERWOLF
CONSTRUCTION First �—
Owner's Address
Owner's E-mail Address
1659 W. ARROW RTE
City UPLAND
State CA Zip 91786 Telephone—
[ 4. Architect/Designer's Name
Last First F Lic. No.
�—
Architect/Designer's Address
Architect/Designer's E-mail Address
City _ -
State Zip F- Telephone
F_ 5. Engineer's Name Last RENKIN First JON Lic. No.
RENKIN
Engineer's Address
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH
State CA Zip90808 Telephone562-353-4680
r-6. Contractor's Name Last INTERFACE SYSTEMS First Lic. No.69046 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 Telephone 562-353-4680
OFFICE USE ONLY�/t
w— PERMIT NO.VIUML o
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TYPE OF CONSTRUCTION
tl n PLAN CHECK NO.
OCCUPANCY- GROUP
�n ft��, Rqp" PLAN CHECK FEE $