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HomeMy WebLinkAboutS2018-0117 - Permit ApplicationQ��`" °R�� WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION V <.�. « CITY OF NEWPORT BEACH ( BUILDING DIVISION PLEAst VKRNI UK i rrt 1. PROJECT ADDRESS (NOT MAILING ADDRESS) &10 11)14Z,14-131,¢12- LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK SWIMMING POOL ❑ SPA M� Check Appropriate box for Applicant 6a2 - _ ESTIMATED $ VALUATION POOL FENCING I� DRAINAGE ©�^ 3. OWNER'S NAME LAST FIRST ADDRESS OWNER'S E-MAIL ADDRESS �n zzl,� halt CITY STATE ZIP 1 e-bcl &/2- 7- ISCA I- PHONE NO. 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. 5. C�ONT/RACTOR'S NAME q 41$I( l'j�li�l27 CCl s��%L[� 1C7�'i,� BUSINESS LICENSE STATE LICENSE 11��77 Class Nb-'&4�� ADDRESS / ��(�l G(,l��l`� C��S-� j-�rGE����� CONTRACTOR'S E-MAIL ADDRESS �J(`h/JG /�u/L���-u� p2r✓'9���1s'�C,G CITY STATE ZIP PHONE NO. :E USE ONLY ^/�'' PERMIT NO. ff S /N (b • owl PLAN CHECK NO. I'(J[p• ��`L� �f �j POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls