HomeMy WebLinkAboutS2023-0247 - Permit Applicationp`�YWYpq� WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
438 Riverside Avenue, Newport Beach, CA 92663
LEGAL DESCRIPTION
LOT 5 BLOCK TRACT 919
2. DESCRIPTION OF WORK Install a prefabricated self contained, portable swim spa partially in -ground with
related 220V electrical service as needed. The swim spa� ESTIMATED $ VALUATION _$40.000
has an ASTM F-1346 safety cover. If If ' F
SWIMMING POOL ❑ SPA ❑x POOL FENCING ❑ DRAINAGE ge
Check AoDronriate box for Annlicant
3. OWNER'SNAME LAST FIRST
Ishikawa / Bowe Mike / Rochelle
ADDRESS
OWNER'S E-MAIL ADDRESS
438 Riverside Avenue
xjedimasterx@roadrunner.com
CITY STATE ZIP
PHONE NO.
Newport Beach CA 92663
949-293-1975
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
IPFIONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Jeremy Campadonia / Rock Bottom Construction Inc.
BT30078983
C27
No. 807474 ClassC10
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
1102 E Carleton Avenue
RBC.807474@gmail.com
CITY STATE ZIP
PHONE NO.
Orange CA 92867
714-296-4849
OFFICE USE ONLY
PERMIT NO. \202540 0214I"
PLAN CHECK NO. �2GZ3 • ZQoZ
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls