HomeMy WebLinkAboutS2020-0161 - Permit ApplicationPrint Form
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Worksheet for Pool Combination Permit Application z e
City of Newport Beacf�
Building Department %%/fl IIP
1. Project Address (Not mailing address)
Legal Description Lot FS Block Tract �ZaS
2. Description of Work
Estimated
Valuation $ 45,
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YN Swimming Pool X Spa r Drainage F- Pool Fencing
Check Appropriate Box for Applicant/Notification Information
lk 3. Owner's Name Last N-5 ,Ar__:
Owner's Address Owner's E-mail Address
City State F_
Zip ciZ LeL� Telephone gqq _Zq5 9 ]�Cp
r 4. Engineer's Name Last cam, First I :; License No 51-t
Engineer's Address Engineer's E-mail Address
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City Fo2�� StateFc� Zip ct Z Telephone 0.
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r 5. Contractor's Name LastFirst Licen(eN\03 O
Contractor's Address Contractor's E-mail Address
City r 1F w�R� State Zip RzV Lr3 Telephone 4�
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PERMIT NUMBER
PLAN CHECK NO
POOL P/C FEE $
DRAINAGE P/C FEE $