HomeMy WebLinkAboutS2022-0200 - Permit Application�` ° "Ar' WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS) 1222 Sandpoint Way I
Corona Del mar, CA 92625
LOT BLOCK TRACT
2. DESCRIPTION OF WORK
EXCAVATE POOL AREA, INSTALL RAISED POOL & SPA W/ INFINITY EDGE,INSTALL BONDING AROUND POOL/SPA,
REPLUMB POOL, INSTALL P-TRAP, INSTALL NEW EQUIPMENT
ESTIMATED $ VALUATION
$154,021.00
SWIMMING POOL ®
SPA
POOL FENCING ❑
DRAINAGE ❑
Check Annronriate how for Annlicant
3. OWNER'S NAME LAST FIRST
Quintin Jordan
ADDRESS
OWNER'S E-MAIL ADDRESS
jordan@hiebschcustom.com
1222 Sandpoint Way
CITY STATE ZIP
PHONE NO.
Corona Del mar CA 92625
(414) 810-9387
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
N4A' 1��S
C53 & C27 C61ID51
PAUL WILLIAMS SSW
No.571196 class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
227 W. CARLETON AVE
PAUL.WILLIAMSQALANSMITHPOOLS.COM
CITY STATE ZIP
PHONE NO.
ORANGE CA 92867
714-423-0179
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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