HomeMy WebLinkAboutF2022-0044 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application o�EW�ge
City of Newport Beach - Building Division o;
F_ Fire Sprinkler (x Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
9242 19TH STREET
�—
City LTA LOMA
1315 BISON AVE
f— 4. Architect/Designer's Name Last
First 7 Lic. No.
Architect/Designer's Address
# Units �-
Tenant Name PANDA EXPRESS #3521
State I— Zip F— Telephone—
r 5. Engineer's Name Last Settlemoir First Mason Lic. No. 469046
2. Description of Work
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH
FIRE ALARM SYSTEM
Use
Contractor's Address
Contractor's E-mail Address
Valuation $
3500.00
Extg Sq Ft F— New/Added Sq Ft F Total Sq Ft F—
908
State CA Zip 08 Telephone 562-353-4680
OFFICE USE ONLY
pZ621 -()338 PERMIT NO. r20z Z -GON t'I
7-Z622
# Stories
F_ New F - Add FX_ Alter r Demo
FEE $ 1s 16, 5 0
Check Appropriate Box for Applicant/Notification
F— 3. Owner's Name Last CUTTING EDGE BUILDERS INC First
Owner's Address
Owner's E-mail Address
9242 19TH STREET
City LTA LOMA
State CA Zip 91701 Telephone—
f— 4. Architect/Designer's Name Last
First 7 Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State I— Zip F— Telephone—
r 5. Engineer's Name Last Settlemoir First Mason Lic. No. 469046
Engineer's Address
Engineer's E-mail Address
3750 SCHAUFELE AVE SUITE 200
City LONG BEACH
State CA Zip 90808 Telephone562-353-4680
F-6. Contractor's Name Last INTERFACE SYSTEMS First F Lic. No. 69046 Class C10
Contractor's Address
Contractor's E-mail Address
3750 SCHAUFELE AVE SUITE 200
kelley.santacruz@interfacesys.com
City L ONG BEACH
908
State CA Zip 08 Telephone 562-353-4680
OFFICE USE ONLY
pZ621 -()338 PERMIT NO. r20z Z -GON t'I
7-Z622
TYPE OF CONSTRUCTION
PLAN CHECK NO. (22"
FEE $ 1s 16, 5 0
OCCUPANCY - GROUP
PLAN CHECK