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HomeMy WebLinkAboutS2022-0036 - Permit Application62022-005tp �` "° "r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION ,� m S y p > a CITY OF NEWPORT BEACH (^v/ C•IC/Y114N" BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS), 2 rue Deauville Newport Beach, CA 92660 LOT BLOCK 1I0.1LON 2. DESCRIPTION OF WORK Resurface spa, Install new drain covers, new trim tile and new LED light ESTIMATED $ VALUATION $7,595.00 SWIMMING POOL ❑ SPA 12 POOL FENCING ❑ DRAINAGE ❑ f -k 1, Annr..nri non hnv fnr Annlicanf 3. OWNER'S NAME LAST FIRST Carle Alyssa ADDRESS OWNER'S E-MAIL ADDRESS 2 rue Deauville CITY STATE ZIP PHONE NO. Newport Beach CA 92660 949-508-1577 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS CITY ; STATES �ZIR; PHONE NO. a 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE C53,C61.D51 Alan Smith Pools No. 571196 class ADDRESS --: CONTRACTOR'S E-MAIL ADDRESS 227 W. CARLETON AVE CITY STATE ZIP PHONE NO. ORANGE CA 92867 714-423-0179 Z USE ONLY PERMIT N0, PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).x15