HomeMy WebLinkAboutS2018-0073 - Permit Applicationl®,o--a01s
<- " WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION S,51019- 00-7.3
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BUILDING DIVISION
- PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
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LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK S \ v
/ ESTIMATED $ VALUATI
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SWIMMING POOL ❑ SPA R POOL FENCING ❑ DRAINAG
t�necK Appropriate oox ror fapput:ant
❑ 3. OWNER'S NAME
LAST
FIRST
Marc
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY
vSTATE
ZIP
PHONE NO.
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CA
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4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
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ADDRESS
ENGINEERE-MAIL ADDRESS
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CITY
STATE
ZIP
PHONE NO.
C/a—
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5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
No. lass
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
CITY
STATE
ZIP
PHONE NO.
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Farms\Pool spa appl (rev3-04).xls
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