HomeMy WebLinkAboutS2018-0186 - Permit Application19, WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
ka CITY OF NEWPORT BEACH
BUILDING DIVISION
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LEGAL
BLOCK TRACT
2. DESCRIPTION OF WORK P+ (7 6 'r
ESTIMATED $ VALUATION
SWIMMING POOL �' SPA a PoGL-FE+C4NG--E3 DRAINAGE
Check Appropriate box for Annlicant
3. OWNER'S NAME LAST FIRST
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ADDRESS
OWNER'S E-MAIL ADDRESS
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CITY STATE ZIP
PHONE NO.
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4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
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ADDRESS
ENGINEER'S E-MAIL ADDRESS
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CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
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BUSINESS LICENSE
STATE LICENSE
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ADDRESS
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CONTRACTOR'S E-MAIL ADDRESS
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CIT STATE ZIP
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PHONE NO.
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USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
rormswooi spa apps (rev6-U4).xis