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Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
707 LIDO PARK DR
Tenant Name LIDO RESIDENCE
2. Description of Work
FIRE SPRINKLERS
41 HEADS
Extg Sq Ft 7 New/Added Sq Ft 7 Total Sq Ft
r New r Add r Alter r Demo
uneck Appropriate Box for Applicant/Notification
Floor Suite No
# Units F—
Use
Valuation $ 4100
# Stories I-
F_ 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State �
Zip F TelephoneF_
(- 4. Architect/Designer's Name
Last
r—
FirstF -----
Lic. No. i
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State I
Zip F Telephonel—
7 5. Engineer's Name Last
FirstF Lic.No.
�—
Engineer's Address
Engineer's E-mail Address
City
State I
Zip F— TelephoneF_
FX_ 6. Contractor's Name Last CASEY First MONTY Lic No. 876004 classF-
Contractor's Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip 90631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. Ajl• 10
TYPE OF CONSTRUCTION
PLAN CHECK NO. 1
OCCUPANCY - GROUP
v, vla PLAN CHECK FEE $