HomeMy WebLinkAboutS2019-0189 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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p ; CITY OF NEWPORT BEACH ol , �ol
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJE T ADDRESS (NOT MAILING ADDRESS)
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1901 A TERRACE, NEWPORT BEACH 92625
LOT 120
BLOCK
TRACT 2813
2. DESCRIPTION OF WORK SHOTCRETE POOL/SPA - APPROX. 395 SQ. FT.: (8) CAISSONS
ESTIMATED $ VALUATION 75,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE ❑
Check Appropriate box for Applicant
3. OWNER'S NAME LAST FIRST
PARKER BOB
ADDRESS
OWNER'S E-MAIL ADDRESS
5 A
1901 SA TERRACE
CITY STATE ZIP
PHONE NO.
NEWPORT BEACH CA 92625
949.493.4374
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
POOL ENGINEERING INC.
74003
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 TUSTIN AVE.
TODDL@POOLENGINEERING.COM
CITY STATE ZIP
PHONE NO.
ANAHEIM CA 92807
1 714.630.6100
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
DEVORE POOLS & SPAS
BT97026761
No.401549 ClassC-53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
PO BOX 828
DEVOREPOOLSPA COX.NET
CITY STATE ZIP
PHONE NO.
SAN JUAN CAPISTRANO CA 92693
949-493-4374
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PERMIT NO. W -1 o2un Cc(
PLAN CHECK NO.
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POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls