HomeMy WebLinkAboutXR2022-2927 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
63 Cambria
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 400 sq ft w/7 Caissons
SWIMMING POOL ® SPA
Check Aonronriate hor fnr Annlicant
ESTIMATED $ VALUATION 80,000
'301c
POOL FENCING ❑ DRAINAGE ❑
® 3. OWNER'S NAME
LAST
FIRST
Bire II LLC
ADDRESS
OWNER'S E-MAIL ADDRESS
63 Cambria
CITY
STATE
ZIP
PHONE NO.
Corona Del Mar
Ca
92625
773.961.8453
❑ 4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
Matt Thompson
86051
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
Montesantos Builders
ADDRESS
No1077463 classB
CONTRACTOR'S E-MAIL ADDRESS
17 Tiburon Bay Drive
CITY
STATE
ZIP
PHONE NO.
Corona Del Mar
Ca
92625
949.239.2022
OFFICE USE ONLY
PERMIT NO.
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CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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