HomeMy WebLinkAboutS2022-0069 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1843 Commodore Rd
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool Remodel, add baja to ex. pool and replaster, gas to fire pit
ESTIMATED $ VALUATION 20,000
SWIMMING POOL ® SPA 0, POOL FENCING ❑ I% DRAINAGE
Check Aonrooriate box for Annlirant
3. OWNER'S NAME LAST FIRST
Welch
ADDRESS
OWNER'S E-MAIL ADDRESS
1843 Commodore Rd
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
714.655.9803
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY STATE ZIP
NO.
TPHONE
Anaheim Ca 92807
14.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Brian's Pool Plastering
INa821323 Class(,
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
7272 Walnut Ave
CITY STATE ZIP
PHONE NO.
Buena Park Ca 90620
714.497.8675
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE PIC FEE $
MLM �
00
FormslPool spa appl (rev3-04).xls