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Associated Building Permit#
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
3001 CAROB ST
Tenant Name LOURES - SANTOS RESIDENCE
2. Description of Work
SPRINKLERS
-ADS
r Fire Sprinkler r Fire Alarm r Fire Misc
Extg Sq Ft F New/Added Sq Ft I Total Sq Ft
Ix New j— Add r Alter I— Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units r
Use
Valuation $ 3900
# Stories F
7_ 3. Owner's Name Last
First
Owner's Address
Owners E-mail Address
City I
State F—
Zip f Telephone[-
1- 4. ArchitectlDesigner's Name
Last First F_ Lic. No.
Architect/Designers Address
ArchitecUDesigners E-mail Address
City I
State F
Zip F Telephoned
j_ S. Engineer's Name Last
First F-- Lic. No.
Engineers Address
Engineers E-mail Address
City
State,
Zip �— TelephoneF_
6. Contractor's Name Last CASEY
First MONTY Lic. No. 876004 Class C-16
Contractor's Address
Contractors E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABARA
State CA
Zip g0631 Telephone 714-476-5370
OFFICE USE ONLY
PERMIT NO. F202 Z— DOq I
TYPE OF CONSTRUCTION
p2,0
PLAN CHECK NO. Qq6 q Z-02 Z
OCCUPANCY - GROUP
AVjA,t %Z7
PLAN CHECK FEE $