HomeMy WebLinkAboutS2022-0195 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
,ARINT OR TYPE
�c JECT ADDRESS (NOT MAILING ADDRESS)
LOT
2. DESCRIPTION OF WORK
SWIMMING POOL 0�
Check Appropriate box for
3. OWNER'S NAMF
BLOCK
TRACT
�"' r 'r 7 ESTIMATED $ VALUATION cq �yf 0 Q �
SPA POOL FENCING ❑ DRAINAGE Qj,�-
tCeA 11%-r2 J"t1114e,
I'l �Ps�r rre ��-
cITY
A J�� STATE
4. ENGINEER'S NAME LAsr C
ADDRESS
/-Tr`��I �"$ l Cl�' q Z �
5. CONTRACTOR'S NAME
,J,5 ADDRESS
CITY
N > r, STATE
CA —
OFFICE USE ONLY p
PERMIT NO. SZOZZ- OC 6S �zo?Z_
PLAN CHECK NO, 1 C 7,0 2-2- 2 33 ?
POOL P/C FEE $
°t--7AS "HnI
t�00S
°' 1 lot i (L" / Class) '
TOR '$ E MAIL ADDRESS.
ZIP PHONE
HONE NO.
6� q�9�=706H
OZ2_GZg6t
DRAINAGE P/C FEE $
villa„ruui spa appl (rev3-04).xls