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HomeMy WebLinkAboutS2021-0264 - Permit Application (2)WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH ''GIF04N BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) LEGAL DESCRIPTION LOT '7'J BLOCK TRACT % 2. DESCRIPTION OF WORK I ESTIMATED $ VALUATION SWIMMING POOL ® SPA( POOL FENCING ❑ Check Aoorooriate box for Aoolicant ©J0 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 �L J L BUSINESS LICENSE STATE LICENSE NO O � C,/ �� Class rr)ADDRESS p II CONTRACTORS E-MAIL ADDRESS I 1 CITY STATE ZIP PHONE NO. OFFICE USE ONLY _ PERMIT NO. - 2�� PLAN CHECK NO. Jai �O�i1 POOL P/C FEE $��� DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).As