HomeMy WebLinkAboutS2021-0072 - Permit Applicationo4�Ew^,,T� WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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CITY UI NEWPORT BEACH S^ 0^ I h^ s-
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1. PROJECT ADDRESS (NOT MAILING ADDRESS)
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2. DESCRIPTION OF WORK 5t4lfA a6 &0 L (L>;Mro Pf� D2�rNFl �� 5� STEM
ESTIMATED$VALUATION
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SWIMMING POOL � SPA LPOOL FENCING �
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ADDRESS
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CITY STATE
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4. ENGINEI�/
R'S NAME
ADDRESS / !�
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CITY STATE
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5. CONTRACTOR'S NAME
ADDRESS
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CITY STATE
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PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
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ZIP PHONE NO.
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RST LICENSE NO.
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NGINEE 'SE -MAIL ADDRESS
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ONTRACTOR'S E-MAIL A
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STATE LICENSE A4-s
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No'1 I eib0 I Class
DDRESS
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P ONE NO.
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DRAINAGE P/C FEE $