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HomeMy WebLinkAboutS2019-0003 - Permit Application®070 -XI4 WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION 5XIq 0003 ' CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOTMAILING ADDRESS) 3632 Blue Key, Newport Beach CA 92625 LEGAL DESCRIPTION LOT 32 BLOCK TRACT 6152 2. DESCRIPTION OF WORK Build a 420sgft in -ground swimming pool, a 64sgft in -ground spa (connected), and install gas line and electrical to Pool equip pool and bbg isESTIMATED $ VALUATION $4n onn SWIMMING POOL ® SPA ® POOL FENCING ❑ - DRAINAGE ❑ Check Appropriate box for Applicant 3. OWNER'S NAME LAST FIR T ��ssj�l� 3c,4^ -r yr ADDRESS OWNER'S E-MAIL ADDRESS L"(i2YJS!`t'li,��� `,yh1rv-) CITY STATE ZIP PHONE NO. 4, ENGINEER'S NAME LAST FIRST LICENSE NO. LaC�YV� —TpiIJ S,ADDRESS ENGINEER'S E-MAIL ADDRESS �urati L /uvI'znc . c6rr CITY STATE ZIP i PHONE NO. ® 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE Levi Capaci BT30040251 No. 868248 Class C5 ADDRESS CONTRACTOR'S E-MAIL ADDRESS 1345 Eolus Avenue levi@capaciwatershapes.com CITY STATE ZIP PHONE NO. Encinitas CA 92024 949-945-8362 ;E USE ONLY PERMIT NO. MC2 e L PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ Formsftol spa appl (rev3-04).ads