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HomeMy WebLinkAboutS2017-0025 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION 1. NROJtGI AUUKtSS (NOT MAILING ADDRESS) 4501 PERHAM, NEWPORT BEACH 92625 LEGAL DESCRIPTION LOT 111 BLOCK TRACT 3357 2. DESCRIPTION OF WORK SHOTCRETE POOL AND SPA 840 SQ. FT SWIMMING POOL ZI ESTIMATED $ VALUATION 150.000 SPA Zj POOL FENCING ❑ Check Appropriate box for Applicant DRAINAGE ❑ Ei 3. OWNER'S NAME LAST FIRST PERHAM, LLC ADDRESS OWNER'S E-MAIL ADDRESS 4501 PERHAM CITY STATE ZIP PHONE NO. NEWPORT BEACH CA 92625 949.756.2525 4. ENGINEER'S NAME LAST FIRST LICENSE NO. POOL ENGINEERING BIEDENBACH CHRIS C-74003 ADDRESS ENGINEER'S E-MAIL ADDRESS 1201 N. TUSTIN CITY STATE ZIP PHONE NO. ANAHEIM CA 92807 714-630-6100 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE DEVORE POOLS & SPAS BT97026761 No.401549 ClassC-5 ADDRESS CONTRACTOR'S E-MAIL ADDRESS PO BOX 828 DEVOREPOOLSPA COX.NET CITY STATE ZIP PHONE NO. SAN JUAN CAPISTRANO CA 92693 949-493-4374 :E USE ONLY PERMIT NO. PLAN CHECK NO POOL P/C FEE DRAINAGE P/C FEE $ iJ�O® " l� Forms\Pool spa app] (rev3-04).xls i(ol'i— ovio to lb — -60c,G 'VQa1'l - ®b (Cp .