HomeMy WebLinkAboutS2023-0085 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
2615 Buckeye Street Newport Beach, CA 92660
LEGAL DESCRIPTION
LOT 440-061-01 BLOCK 76 TRACT 4892
2. DESCRIPTION OF WORK New Pool 12'x24' and Spa TxT (296 SF of Surface Area
ESTIMATED $ VALUATION $25,000
SWIMMING POOL x❑ SPA ❑x POOL FENCING ❑ DRAINAGE ❑
Check Appropriate box for Applicant
3.
OWNER'S NAME LAST
FIRST
Odiorne, Dennis
ADDRESS
OWNER'S E-MAIL ADDRESS
2615 Buckeye Street
denniso@regentscapital.com
CITY STATE
ZIP
PHONE NO.
Newport Beach, CA 92660 " }ni
(310) 292-9047
4.
ENGINEER'S NAME LAST
FIRST
LICENSE NO.
74003
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Avenue
info@pooleng.com
CITY STATE
ZIP
PHONE NO.
Anaheim, CA 92807
(714) 630-6100
5.
CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Westmod
�No. 1053685 ClassC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
1276 E. Colorado Blvd Suite 210
reina@westmoddesign.com
CITY STATE
ZIP
PHONE NO.
Pasadena, CA 91106
(626) 251-5744
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO. 1i2NZ,;?2 e 01(3
POOL P/C FEE $
DRAINAGE P/C FEE $ 1 �� 2. Loo1
Fonns\Pool spa appl (rev3-04).xls