HomeMy WebLinkAboutF2022-0234 - Permit Application2 d lac 3 ` ' ► 6 qi leek
Worksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # jX Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1641 REEF VIEW
Tenant Name HAKES RESIDENCE # Units
2. Description of Work
_
FIRE SPRINKLERS
Use
29 HEADS
Extg Sq Ft New/Added Sq Ft Total Sq Ft
Valuation $ 2900
#Stories �1
r New j— Add F_ Alter r Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last First'
Owner's Address
Owner's E-mail Address
City
State Zip F TelephoneF—
j- 4. Architect/Designer's
Name Last First � Lic. No. —
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip Telephoned
F- 5. Engineer's Name
Last First I Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State � Zip F_ Telephoned
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 190631 Telephone 714-4776-5370
OFFICE USE ONLY
f12,0 7' UZ� PERMIT NO. t' 2- ZZn — 0Z 3It
�
/�
TYPE OF CONSTRUCTION lS V _tz L- AJdI"�I
PLAN CHECK NO. ` 1 qv' ZOZz
XV �1-1116 Z2Z . 00 `
OCCUPANCY -GROUP
PLAN CHECK FEE $