HomeMy WebLinkAboutF2022-0054 - Permit ApplicationWorksheet for Fire Permit Application
-Print Form ' City of Newport Beach - Building Division o
Please print 3 copies f 02 '1 � 0o5y
Associated Building Permit # 61�> r, Fire Sprinkler [ Fire Alarm ` Fire Misc
I- Project Address (Not mailing address) Floor Suite No
1436 NEWPORTER WAY �— F_
Tenant Name HOGAN RESIDENCE # Units—'!
2. Description of Work
Use'�C V
FIRE SPRINKLERS
26 HEADS
J
Zip F7777 TelephoneF—
Valuation $ 2600-
(�
Extg Sci Ft I New/Added Sci Ft Total Sci Ft ��
First Lic. No.
ArchitecUDesigner's Address
# Stories
r, New F- Add F_ Alter I- Demo
City
Check Appropriate Box for Applicant/Notification
J_- 3. Owner's Name
Last
First F_
Owner's Address
Owner's E-mail Address
City
State
Zip F7777 TelephoneF—
r- 4. Architect/Designees
Name Last
First Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State F_
ZipF— Telephoned
F_I 5. Engineer's Name
Last � First F_ Lic No.
Engineer's Address
Engineer's E-mail Address
City �—
State F
Zip �,' Telephoned
r'; 6. Contractor's Name
Last [CASEY First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip 90631 Telephone714-476-5370
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. O L712
OCCUPANCY- GROUP
7 PLAN CHECK FEE $