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HomeMy WebLinkAboutS2022-0075 - Permit Application�OZCD A- 0 2c WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 22 Via Diamonte LEGAL DESCRIPTION LOT BLOCK TRACT -( 40a4- I0M 5 as Vlk RCAOhh-e 2. DESCRIPTION OF WORK Pool and Spa 246 sq ft ESTIMATED $ VALUATION 36,000 SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE Check Aonrooriate box for Aoolicant 3. OWNER'S NAME wsr FIRST Nowzari ADDRESS OWNER'S E-MAIL ADDRESS 22 Via Diamonte CITY STATE ZIP PHONE NO. Newport Coast Ca 92657 949.350.0837 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 -7 Premier Pools and Spas No. Class ADDRESS CONTRACTOR'S E-MAIL ADDRESS 26052 Merit Circle #106 CITY STATE ZIP PHONE NO. Ca Laguna Hills 92653 949.215.4144 :E USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ 07 DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls