HomeMy WebLinkAboutS2020-0168 - Permit ApplicationS2a71v— 0►w�
.. WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1307 Oxford Ln
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 384 Sq It
Gas and Electric to BBQ ESTIMATED $ VALUATION 39,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE EZI
Check Appropriate box for Applicant
3. OWNER'S NAME LAST FIRST
Sandland Scott
ADDRESS
OWNER'S E-MAIL ADDRESS
1307 Oxford
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
949.302.9541
E] 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Matt
Thompson
86051
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
1714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Orange County Pools & Spas
iNo:423815 ClassC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
17762 Leafwood
CITY STATE ZIP
PHONE NO.
Santa Ana Ca 92705
714.322.4600
USE
NLY
OFFICEERMITONO. t_J W W -Dya,0 �•' f, 1501
PLAN CHECK NO. IS&I�/' V
POOL P/C FEE $
DRAINAGE P/C FEE $ V
Fomsll-ool spa appl (rev3-04).xls