HomeMy WebLinkAboutS2021-0286 - Permit Application2 0Z 1 - 0-2-8� e
4 """�`"r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
8 Boardwalk
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool 356 sq It
ESTIMATED $ VALUATION 42,000
SWIMMING POOL ® SPA ❑ POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
3. OWNER'S NAME LAST FIRST
David Fiori
ADDRESS
OWNER'S E-MAIL ADDRESS
8 Boardwalk
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
714.392.1900
❑ 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lenehan Kyle
82227
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1024 Iron Point Ste 100-1486
CITY STATE ZIP
PHONE NO.
Folsom Ca 95630
1916.287.1445
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Premier Pools and Spas
No. 798298 Class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
26052 Merit Circle #106
CITY STATE ZIP
PHONE NO.
Laguna Hills Ca 92653 1949.215.4144
OFFICE USE ONLY
PERMIT NO. SLO2I pti$t,
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls