HomeMy WebLinkAboutS2018-0219 - Permit ApplicationS20It) - 02-�q
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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CITY OF NEWPORT BEACH (.
BUILDING DIVISION
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1. PROJECT ADDRESS (NOT MAILING ADDRESS)
-51a- 51v10^-1-
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK P00 L f (f nAC-✓l-0-C- o(i1 ✓u & y:
e- I4Ae 1 ( P'5� ! G�7 (� ESTIMATED $ VALUATIONS
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SWIMMING POOL SPA E ✓I / POOL FENCING ❑
Check Aoorooriate box for Applicant
DRAINAGE ❑
3. OWNER'S NAME LAST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
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4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
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ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
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CITY STATE ZIP
PHONE NO.
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:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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