HomeMy WebLinkAboutS2020-0061 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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CITY OF NEWPORT BEACH
BUILDING DIVISION
VLCAJC MINI VK
(NOT MAILING ADDRESS)
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LEGAL
TRACT
2. DESCRIPTION OF WORK NeJ TOOL, 48(41P G A -S '
Y (� /` OO(' 305 ESTIMATED $ VALUATION
SWIMMING POOL Li� SPA ff""� PQ96 FF=P!G W, -Q, DRAINAGE
Check Appropriate box for Aonlicant
3. OWNER'S NAME LAST FIRST
CL�ss� P�,��
ADDRESS Q�
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
4. ENGINEER'S] NAM�E�1_ n LAST FIRST
LICENSE NO.
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INEER'S E-MAIL ADDRESS
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CITY STATEZIP
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PHONE NO.
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rw 5. CO/N/-XR��A(fCCTOR'S NAME
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BUSINESS LICENSE
STATE LICENSE /�!7
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No -507 Class
ADDRESS
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CONTRACTOR'S E-MAIL ADDRESS
CITY STATE n n�JZZIPPHONENCO.
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OFFICE USE ONLY
PERMIT NO. �� �� M, � �"fmoo
PLAN CHECK NO. �1 �� w �G 1!�Ri►�]fA�/rI/ a 01
POOL P/C FEE $ • 6 00
DRAINAGE P/C FEE $
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