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°R WORKSHEET FOR POOL COMBINATION PERMIT APPLICAT
U CITY OF NEWPORT BEACH
BUILDING DIVISION
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LOT BLOCK
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SWIMMING POOL E!r' SPA POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
3. OWNER'S NAME
LAST
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ADDRESS
OWNER'S E-MAIL ADDRESS
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4. ENGINEER'S NAME
LAST
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LICENSE NO.
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ENGINEER'S E-MAIL ADDRESS
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5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
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PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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