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
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ADDRESS
OWNER'S E-MAIL ADDRESS
L"(i2YJS!`t'li,��� `,yh1rv-)
CITY STATE ZIP
PHONE NO.
4, ENGINEER'S NAME LAST FIRST
LICENSE NO.
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S,ADDRESS
ENGINEER'S E-MAIL ADDRESS
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CITY STATE ZIP
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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