HomeMy WebLinkAboutS2022-0080 - Permit Application"`w"°"r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
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BUILDING DIVISION
PI FARF PRINT OR TVPF
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
4 Shadowcast Newport Coast, CA 92657
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Replaster spa, Replace drain covers, Replace LED light, Replace Tile,
Install new stucco to water feature wall ESTIMATED $ VALUATION $17,506.00
SWIMMING POOL ❑ SPA ® POOL FENCING ❑ DRAINAGE ❑
Chank Annrnnriata hnY fnr Annlicant
3. OWNER'S NAME LAST FIRST
Fessenden Scott
ADDRESS
OWNER'S E-MAIL ADDRESS
4 Shadowcast
scf712@cox.net
CITY STATE ZIP
PHONE NO.
Newport Coast CA 92657
(949) 705-8172
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICENSE
Paul Williams
571196 C53/C61/D51
No. Class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
227 W. Carleton Ave
Paul.Williams@alansmithpools.com
CITY STATE ZIP
PHONE NO.
Orange CA 92867
714-423-0179
OFFICE USE ONLYn G n /10 & be.,PERMIT NO. G� G V 60
PLAN CHECK NO.
09 dN - 2ooz 2
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xis