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HomeMy WebLinkAboutS2018-0085 - Permit Application.2673 LOT `�-) �-O 1,-6 - O04i5:j WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION CITY OF NEWPORT BEACH J BUILDING DIVISION (NOT MAILING ADDRESS) 2. DESCRIPTION OF WORK 0 fA-10JVC*1 pp510ESTIMATED SWIMMING POOL L/ SPA ❑ POOL FENCING Check Appropriate box for Applicant TRACT $ VALUATIO 3U,yD ❑ DRAINAGE 3. OWNER'S NAME LAST FIRST d.A A/ � e� r ADDRESS 2,67' a� SSWb pp S'T�-P e r - OWNER'S E-MAIL ADDRESS CITY STATE ZIP 1✓Pwfov✓4 grj4C-H C -A. PHONE NO. rl 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 .%-CAJWA/J! /4ULS 7(o 73 25- Noo.. Class ADDRESS 00 CONTRACTOR'S E-MAIL ADDRESS 6ep(@ do4wit!'i/Voo).rco CITY STATE ZIP jPrONE 0. OFFICE USE ONLY PERMIT NO. PLAN CHECK NO. v POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls