HomeMy WebLinkAboutS2023-0095 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
s
CITY OF NEWPORT BEACH
BUILDING DIVISION
911a_F9aUN10110][iEAU =
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
14 Via Rubino
LEGAL DESCRIPTION
LOT 478-171-09 BLOCK TRACT
I `P V/,3, P' b na
2. DESCRIPTION OF WORK New Spa D
1 ESTIMATED $ VALUATION $30,000
SWIMMING POOL ❑ SPA yJ POOL FENCING ❑ DRAINAGE ❑
/ Check Appropriate box for Applicant
3. OWNER'S NAME
LAST
FIRST
Sabouni
Ali
ADDRESS
OWNER'S E-MAIL ADDRESS
14 Via Rubino
CITY
STATE
ZIP
PHONE NO.
Newport Coast
CA
92657
4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY
STATE
ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
OC Poolscapes
1061813
No. 53 Class C
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
2961 W MacArthur Blvd #128
info@ocpoolscapes.com
CITY
STATE
ZIP
PHONE NO.
Santa Ana
CA
92704
949-444-3629
OFFICE USE ONLY
PERMIT N0.
) ®/
SI�Z� �j` "✓
PLAN CHECK NO.
POOL P/C FEE $
r/ ,V
1C
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls