HomeMy WebLinkAboutS2021-0116 - Permit ApplicationA
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
PLEASE PRINT OR TY e BUILDING DIVISION �)Zo L 1- o l l u
1. PROJECT ADDRES
AILINGAQQRES
2 fIr�lYnld W _l.
_LEGAL DESCRIPTION
LOT
FFDESCRIPTION OF WORK
L
I' Check Appropriate box for
3. OWNER'S NAME
ADDRESS
CITY
11P 4
Eli
rS
nq um�[55
ADDRESS
'-LI-512
5T�y
CE USUS
PERMIT NO,
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C. FEE $
FormslPool spa appl (rev3-o4).xls
BLOCK
TRACT
ESTIMATED $ VALUATION > /c�J
SPA u ENt ING
DRAINAGE
kpplicant
LAST FIRST
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`` OWNER'S E-MAIL ADDRESS
ZIP � PHc�O ENO. LAST FIRS 77Y"`S,
LICENSE NO.
2-
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rnVlVt NO.