HomeMy WebLinkAboutS2021-0012 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT AP ION
CITY OF NEWPORT BEACH
BUILDING DIVISION S
2. DESCRIPTION OF WORK Pool and Spa 441 Sq It
Gas and Electric to bbq and fire pit ESTIMATED $ VALUATION 45,000
SWIMMING POOL ® SPA
Check ADDrODriate box for Annliem .r
POOL FENCING ❑ DRAINAGE
OWNER'S NAME
:3.
LAs
FIRSo11a
Mike
OWNER'S E-MAIL ADDRESS
[ADDRESS
1606 Antigua Way
CITY
STATE
ZIP PHONE NO.
ewport Beach
Ca
4. ENGINEER'S NAME
LAST
92660 949278.3802
FIRST LICENSE NO.
Biedenbach
Chris
ADDRESS
74002
ENGINEER'S E-MAIL ADDRESS
1201 N Tustin Ave
CITY
STATE
ZIP PHONE NO.
Anaheim
Ca
92807 714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICENSE
Swan Pools
ADDRESS
No. ClassC53
CONTRACTOR'S E-MAIL ADDRESS
24512 Bridger Rd
CITY
STATE
ZIP PHONE NO.
Lake Forest
Ca
92630
949.859.8466
X USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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FOMSIP001 spa appl (rev3-04).,ds 9 Z-0 Zi t — C) C)