HomeMy WebLinkAboutX2020-2398 - Permit Application (5)WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH X?,02.043plq
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK
SWIMMING POOL SPA
CEZ
Check Appropriate box for Applicant
Cod -A
ESTIMATED 6 VALUATION G� CSS
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S NAME LAST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
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4. ENGINEER'S NAME sT FIRST
LICENSE NO.
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ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICE7NSEU
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
CITY STATE- ZIP
PHONE NO.
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (mv3-04).xls