HomeMy WebLinkAboutS2021-0019 - Permit ApplicationWORKSHEET FOR POOL COMBI
CITY OF NEW
BUILDING
PLEASE PRINT OR TYPE
NATION PERMIT APPLICATION . \ jyi i on of
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1. PROJECT ADDRESS (NOT MAILING ADDRESS)
2301 Alta -Vista Dr
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 471 sq ft
ESTIMATED $ VALUATION 46,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE EZ
Check Appropriate box for Applicant
3. OWNER'S NAME LA r FIRST
Akins Bruce
ADDRESS
OWNER'S E-MAIL ADDRESS
2301 Alta Vista
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
949.232.9149
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N- Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Promontory Pools
No. C12LSCI
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
17401 Irvine Blvd #B
CITY STATE ZIP
PHONE NO.
Tustin Ca 92780 1714.508.0557
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Formsftol spa appl (rev3-04).xls
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