HomeMy WebLinkAboutS2020-0186 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
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LEGAL DESCRIPTION
LOT BLOCK
TRACT
2. DESCRIPTION OF WORK 5),
ESTIMATED $ VALUATION oZ S ' c L>
SWIMMING POOL ❑ SPA b " POOL FENCING ❑ DRAINAGE ❑
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3. OWNER'S NAME LAST
FIRST
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ADDRESS
OWNER'S E-MAIL ADDRESS
CITY )
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STATE
p ZIP PHONE NO.
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4. ENGINEER'S NAME LAST
FIRST LICENSE NO.
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ADDRESS
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ENGINEER'SE-MAIL ADDRESS
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CITY
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STATE
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ZIP PHONE NO.
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5. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICENSE
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ADDRESS
Class
CONTRACTOR'S E-MAIL ADDRESS
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STATE
ZIP
PHONE NO.
OFFICE USE ONLY
PERMIT NO.
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PLAN CHECK NO, Y � j ZF�
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POOL P/C FEE $
DRAINAGE P/C FEE $
rurmsxrooi spa appi (rev:7-04).xls