HomeMy WebLinkAboutS2018-0072 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH S%D lcb- ®O1 2—
BUILDING DIVISION
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1. PROJECT ADDRESS (NOT MAILING ADDRESS)
5 COLLINS iM., NEWPORT BEACH 92662
LOT 4
2. DESCRIPTION OF
SWIMMING POOL ❑
BLOCK
TRACT 1
SHOTCRETE SPA 45 SQ. FT; WATERFEATURE - APPROX. 9 SQ. FT.
ESTIMATED $ VALUATION 50.000
SPA ® POOL FENCING ❑ DRAINAGE ❑
Check Appropriate box for Applicant
3. OWNER'S NAME LAST FIRST
THABIT CORY
ADDRESS
OWNER'S E-MAIL ADDRESS
5 COLLINS RD.
CITY STATE ZIP
PHONE NO.
NEWPORT BEACH CA 92662
949.872.7282
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
POOL ENGINEERING TODD LACHER
C-67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. TUSTIN
CITY STATE ZIP
PHONE NO.
ANAHEIM CA
1 714-630-6100
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
DEVORE POOLS & SPAS
BT97026761
iNo.401549 ClassC-53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
PO BOX 828
DEVOREPOOLSPA COX.NET
CITY STATE ZIP
PHONE NO.
SAN JUAN CAPISTRANO CA 921 1
949-493-4374
'E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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Forms\Pool spa appl (rev3-04).xls YZ 11
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