HomeMy WebLinkAboutS2020-0067 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION s zo&o oo L 7
0 4 CITY OF NEWPORT BEACH ,\
BUILDING DIVISION
MCA= rKIK 1 VK 1 TrC
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
2325 E. 16th Street, Newport Beach, CA 92663
LEGAL DESCRIPTION APN: 425-303-31
LOT BLOCK TRACT
2. DESCRIPTION OF WORK
SWIMMING POOL ® SPA 91
Check Appropriate box for Applicant
Pool and Spa 1'31ox Z-1 L ft VO$})
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ESTIMATED $ VALUATION �'{ 01 Doc" -
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S NAME LAST FIRST
ADDRESa �j
-54LT � /
OWNER'S E-MAIL ADDRESS
C STATE ZIP
PHONE
G�
1NO. 7�
4. ENGI ER'S NAME LAV FIRST
LICENSE NO.
Pool'Engineering, Inc.
74003
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
info@pooleng.com
CITY STATE ZIP
PHONE NO.
Anaheim California 92807
714-630-6100
❑ 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Masterpiece Pools & Spas, Inc.
BT30065990
lNo. 804110
classC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
22343 La Palma Ave., Suite 104
mike@masterpiecepoolsandspas.com
CITY STATE ZIP
PHONE NO.
Yorba Linda California 92887
714-692-1132
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
FormslPool spa appl (rev3-04).xls