HomeMy WebLinkAboutF2022-0011 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building P
Worksheet for Fire Permit Application
City of Newport Beach - Building Divir( t '
r Fire Sprinkler r Fire Alarm Fire Misc
Floor Suite No
1. Project Address (Not mailing address)
1087
1087 NREPORT CENTER DRIVE
# Units �—
Tenant Name RAY BAN
Use
2. Description of Work ED
PROTECTED PREMISES FIRE ALARM SYSTE 4�
Valuation $ 5000.00
Extg Sq Ft F— New/Added Sq Ft �— Total Sq Ft F
# Stories q
F-New F_ Add FX- Alter r- Demo
Check Appropriate Box for Applicant/Notif!cation
information
F_ 3. Owner's Name Last PRIME CONTRACTING First �—
Owner's Address Owner's E-mail Address
1715 ENTERPRISE CIR N STE 105C
State CA Zip 92590 Telephone[
City EMECULA
First F
Lic. No.
F_4. Architect/Designer's Name Last
Architect/Designer's Address Architect/Designees E-mail Address
State F— Zip
�— Telephoner
City
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 LONGBEACH State CA Zip90808 Telephone562-353-4680
Lic. No. 69046 Class C10
r 6. Contractor's Name Last INTERFACE SYSTEMS First �—
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
PERMIT NO. vv
OFFICE USE ONLY ,�''
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY -GROUP s %® �i r/ PLAN CHECK FEE $ --