HomeMy WebLinkAboutXR2022-3322 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit#
?6WFORT
Worksheet for Fire Permit Application a
City of Newport Beach - Building Division o
IX Fire Sprinkler F_ Fire Alarm (- Fire Misc
1. Project Address (Not mailing address)
1424 Galaxy Drive Newport Beach, CA
Tenant Name Chen Residence
2. Description of Work
FIRE SPRINKLERS
39 HEADS
Extg Sq Ft F— New/Added Sq Ft F Total Sq Ft
( ] New F- Add F- Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Floor
Suite No
# Units
Use
Valuation $ 3900
# Stories 1
17 3.Owner's Name Last
First
Owners Address
Owner's E-mail Address
City �
State 7— Zip r Telephoned
r- 4. Architect/Designer's Name Last
First F Lic. No.
Architect/Designer's Address
----_
Architect/Designer's E-mail Address
-
City
_ -
State Zip [ TelephoneF
Fi 5. Engineer's Name Last (
_ _ FirstF Lic No.
Engineer's Address
Engineer's E-mail Address
City
State Zip F—. TelephoneF—
jK'.6. Contractor's Name Last CASEY
First MONTY Lic No. 876004 Class C-16
Contractors Address
Contractor's E-mail Address _
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State ICA Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY PERMIT NO. �.2
ICJ C
,.[ TYPE OF CONSTRUCTION
PLAN CHECK NO. C-Z&e�_
OCCUPANCY -GROUP
�f �7 -Z - / �(% PLAN CHECK FEE $