HomeMy WebLinkAboutS2020-0107 - Permit Application (2)WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING nI\/I.R1nN
PLEASE PRINT OR TYPE - - - - - - - - U 9 U i
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
10 Night Sky
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 789 sq ft
ESTIMATED $ VALUATION 75,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE 171
Check Appropriate box for Ann[icant
® 3. OWNER'S NAME LAT FIRST
Itri Mark
ADDRESS
OWNER'S E-MAIL ADDRESS
10 Night Sky
CITY STATE ZIP
PHONE NO.
Newport Coast Ca 92657
714.331.9860
® 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N Tustin
CITY STATE ZIP
PHO -NEN O.
Anaheim Ca 92807
714.630.6100
5. ('0611 HAC I OR'S NAME
BUSINESS LICENSE STATE LICENSE
Bret Steele (Steele Pools)
ADDRESS
No. 923975 clas�53
CONTRACTOR'S E-MAIL ADDRESS
4921 E.Leeds
CITY STATE ZIP
PHONE NO.
Orange Ca 92867
714.496.1427
OFFICE USE ONLY
i
PERMIT NO.�
PLAN CHECK NO. {
POOL P/C FEE $
DRAINAGE P/C FEE $
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