HomeMy WebLinkAboutS2021-0053 - Permit ApplicationA
f 'n
PLEASE PRINT OR TYF
1. PROJECT ADDREE
5 Whitesands Dr
LOT
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY NEWPORT BEACH �n ozl --005 I5
BUILDING DIVISION L �J�/'V
(NOT MAILING ADDRESS)
2. DESCRIPTION OF WORK Pool and Spa 720 sq ft
GAG ti U60Tv--1. 6eQ-/ ree-PLAm -5-''5
SWIMMING POOL ® SPA EZ
Check Appropriate box for Applicant
TRACT
ESTIMATED $VALUATION 22,v5
POOL FENCING ❑ DRAINAGE
3. OWNER'S NAME LAST FIRST
Schwetz Myck
ADDRESS
OWNER'S E-MAIL ADDRESS
5 Whitesands Dr
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92657
949.500.2366
❑ 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
ADDRESS
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
Orange County Pools
INO. 839719 Class C5
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
960 6th St #101A-148
CITY STATE ZIP
PHONE NO.
Norco Ca 92860
714.225.2907
OFFICE USE ONLY
PERMIT NO. , �7,o-a✓1 , ppS'3 X( . o*q-
a�
PLAN CHECK NO. 119
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls