HomeMy WebLinkAboutS2022-0060 - Permit Applicationot,$,v> ° WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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BUILDING DIVISI N
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK
SWIMMING POOLQ�,
SPA G*-
Check Appropriate box for Aaalicant
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_ ESTIMATED $ VALUATION 50 (C
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S NAME LAST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE " .
STATE LICENSE
No.�Clas
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
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CITY STATE ZIP
ONE NO.
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L-7,
:E USE ONLY
PERMIT NO.
PLAN CHECK NO. �4.'✓ ��
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls
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