HomeMy WebLinkAboutS2021-0088 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION AZO ZI - �Og`6
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
306 St Andrews Rd
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 580 sq ft
Gas and Electric to Estsu an
patio area ESTIMATED $ VALUATION 42,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE EZ
Check Appropriate box for Aonlicant
❑ 3. OWNER'S NAME
LAST
FI T
Allison
ADDRESS
OWNER'S E-MAIL ADDRESS
306 St Andrews Rd
CITY
STATE
ZIP
PHONE NO.
Newport Beach
Ca
92660
714.232.1125
4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
Thompson
Matt
86051
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY
STATE
ZIP
PHONE NO.
Anaheim
Ca
92807
1714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Grant Gaspar
INO.sass C5
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
22982 Vesper Rd
CITY
STATE
ZIP IPHONE
NO.
Lake Forest
Ca
92630 1949.683.6955
OFFICE USE ONLY
PERMIT NO. C/?AZ'r ��t'Z �U2����✓ S7A7�.A7114
PLAN CHECK NO. V t�I • IN�-�
POOL P/C FEE $
DRAINAGE P/C FEE $
I-o"SIF001 spa appl (rev3-04).)ds