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HomeMy WebLinkAboutS2022-0003 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) /� 11 OFFSHORE, NEWPORT BEACH 92657 C(n Gt �U4 LEGAL DESCRIPTION LOT 52 BLOCK TRACT 15918 2. DESCRIPTION OF WORK POOL/SPA, (16) CAISSONS SWIMMING POOL Check Appropriate box for Applicant ESTIMATED $ VALUATION 125,000 POOL FENCING ❑ DRAINAGE ❑ ❑ 3. OWNER'S NAME LAST FIRST STUPIN ANDREW ADDRESS OWNER'S E-MAIL ADDRESS 11 OFFSHORE CITY STATE ZIP PHONE NO. NEWPORT BEACH CA 92657 949.370.9576 4. ENGINEER'S NAME LAST FIRST LICENSE NO. PMA ENGINEERING PETROV PLAMEN SE-66947 ADDRESS ENGINEER'S E-MAIL ADDRESS 28161 CASITAS CT. P.PETROV@PMA-BG.COM CITY STATE ZIP PHONE NO. LAGUNA NIGUEL CA 92677 714.717.7542 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE DEVORE POOLS & SPAS BT97026761 No.401549 ClassC-53 ADDRESS CONTRACTOR'S E-MAIL ADDRESS PO BOX 828 DEVOREPOOLS COX.NET CITY STATE ZIP PHONE NO. SAN JUAN CAPISTRANO CA 92693 949.370-9576 OFFICE USE ONLY 2�A PERMIT N0. PLAN CHECK NO. 1 POOL P/C FEE $ 1c] e' 1 DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION x r r't ,i f PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 11 OFFSHORE, NEWPORT BEACH 92657 LEGAL DESCRIPTION LOT 52 BLOCK TRACT 15918 2. DESCRIPTION OF WORK POOL/SPA, ( 16 ) CAISSONS ESTIMATED $ VALUATION 125,000 SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE ❑ Check Appropriate box for ADolicant ❑ 3. OWNER'S NAME LAST FIRST STUPIN ANDREW ADDRESS OWNER'S E-MAIL ADDRESS 11 OFFSHORE CITY STATE ZIP PHONE NO. NEWPORT BEACH CA 92657 949.370.9576 4. ENGINEER'S NAME LAST FIRST LICENSE NO. PMA ENGINEERING PETROV PLAMEN SE-66947 ADDRESS ENGINEER'S E-MAIL ADDRESS 28161 CASITAS CT. P.PETROV@PMA-BG.COM CITY STATE ZIP PHONE NO. LAGUNA NIGUEL CA 92677 714.717.7542 Fj 5. NTR CT R' N j�E BUSINESS LICENSE STATE LICENSE 1 No. ClassC-53 ADDRESS CONTRACTOR'S E-MAIL ADDRESS 28 ET CITY STATE ZIPS PHONE NO. S�,N_JtVA-k LCAP 9-2693 1942�,- 76 ' OFFICE USE ONLY �f ��IJ`� Well) PERMIT NO. (320 C' '� �7 � liy71-- PLAN CHECK NO. POOL PIC FEE $ 19 DRAINAGE PIC FEE $ Forms\Pool spa appl (rev3-04).xls r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION J�/�� PLEASE PRINT OR TYPE VOW) �{�1 1 ) 1. PROJECT ADDRESS (NOT MAILING ADDRESS) " 11 OFFSHORE, NEWPORT BEACH 92657 LEGAL DESCRIPTION LOT 52 BLOCK TRACT 15918 2. DESCRIPTION OF WORK POOL/SPA, ( 16) CAISSONS SWIMMING POOL ® SPA Check Appropriate box for Applicant ESTIMATED $ VALUATION 125.000 POOL FENCING ❑ DRAINAGE ❑ 3. OWNER'S NAME LAST FIRST STUPIN ANDREW ADDRESS OWNER'S E-MAIL ADDRESS 11 OFFSHORE CITY STATE ZIP PHONE NO. NEWPORT BEACH CA 92657 949.370.9576 4. ENGINEER'S NAME LAST FIRST LICENSE NO. PMA ENGINEERING PETROV PLAMEN SE-66947 ADDRESS ENGINEER'S E-MAIL ADDRESS 28161 CASITAS CT. P.PETROV@PMA-BG.COM CITY STATE ZIP PHONE NO. LAGUNA NIGUEL CA 92677 714.717.7542 ® 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE DEVORE POOLS & SPAS BT97026761 No.401549 ClassC-53 ADDRESS CONTRACTOR'S E-MAIL ADDRESS PO BOX 828 DEVOREPOOLS COX.NET CITY STATE ZIP PHONE NO. SAN JUAN CAPISTRANO CA 92693 949.370-9576 OFFICE USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ ( S20'zzA C� , Zo22~r�l Z(,ZoZZ 6D1 � • 202� GY) t Ig 7-+s— 1 Forms\Pool spa appl (rev3-04).xls