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HomeMy WebLinkAboutS2022-0158 - Permit Application"WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION F � f CITY OF NEWPORT BEACH 1--, ,� S "?"� b�se BUILDING DIVISION ni EASE PRINT OR TYPE 1. PROJECT ADDRRESS (NOT MAILING ADDRESS) t235 SctY►r� l�� oavlU oei MoirCA. Z LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK �pI01C� r01 •Yet 1 l2 �001 1V1St�t 11 V12u) olt�OH K1 Cove. virlfW k ) eml p MW yley) :61±2rC ESTIMATED $ VALUATION SWIMMING POOLSPA ❑ POOL FENCING ❑ DRAINAGE ❑ I�6.e..1. Annrnnria4n hnx fnr Annlir-ant - ••-- • - -1-1-- -V - --- -- - - - ❑ 3. OWNER'S NAME LAST ip,,y FIRST S1 ADDRESS 12-?,G5 So1U1(% V'--eg OWNER'S E-MAIL ADDRESS Syr>�bc k3� ,@gVYIC k1 ,cnv� CITY �r���� � M(4 STATE CA- ZIP9 2(02e PHONE NO. CcWl) ZllA— c10(o ❑ 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. ❑ 5. CONTRACTOR'S NAME '(,((/� S � b0 S BUSINESS LICENSE STATE LICENSE (.,(01 V>5II, No.511�cjClass ADDRESS 22-7 vV CA(--e-j-Qw) Akje CONTRACTOR'S E-MAIL ADDRESS Amf(ek f kowz :." 6010 SWt , th CITY STATE C/4. ZIF92-00-] PHONE NO. (� VAI�e �ll l 4) 23Z -lo`? V'Z :E USE ONLY PERMIT NO. PLAN CHECK NO POOL P/C FEE $ S,7A22- OISS pctozz -lSo9 DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls :E USE ONLY PERMIT NO. PLAN CHECK NO POOL P/C FEE $ S,7A22- OISS pctozz -lSo9 DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls