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HomeMy WebLinkAboutS2020-0026 - Permit Application"`' '"kr;� WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION U�� CITY OF NEWPORT BEACH BUILDING DIVISION S ��. D 0 PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 3712 Channel Place, Newport Beach, CA 92663 LEGAL DESCRIPTION LOT BLOCK TRACT 2..^ESCRIPTION OF WORK Fiberglass Pool Installation ESTIMATED $ VALUATION 28,500 ;MING POOL x❑ SPA ❑ POOL FENCING ❑ DRAINAGE ❑ box for Wells Winfield ADDRESS .'3712 Channel Place OWNER'S E-MAIL ADDRESS winfieldwells@gmail.com CITY STATE ZIP PHONE NO. Newport Beach - CA 92663 (323)573-4055 ENGINEER'S NAME LAST FIRST LICENSE NO. Poindexter Donald C24420 ADDRESS I ENGINEER'S E-MAIL ADDRESS ,10140 Starr Road I CITY STATE HONE NO. (indsor CA 95492=707-495-0420 =BUSINESS CONTRACTOR'S NAME LICENSE STATE LICENSE ' V -1-P. Construction ADDRESS No. 664861 Class C53 - CONTRACTOR'S E-MAIL ADDRESS " 22365 E1 Toro Rd., #201 Vipcoinc@gmail.com CITY STATE ZIP PHONE NO. Lake Forest CA 92630 949-444-2286 r"I-C Uar vivLY PERMIT NO. PLAN CHECK NO, POOL P/C FEE $ DRAINAGE P/C FEE $ FormslPool spa appl (rev3-04) An