HomeMy WebLinkAboutS2020-0132 - Permit Application�` WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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<r,;,w��� � CITY OF NEWPORT BEACH
PLEASE PRINT OR TYPE BUILDING DIVISION ' I
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
12 Vernon
LEGAL DESCRIPTION
LOT BLOCK
TRACT
2. DESCRIP41ON OF WORK Pool and Spa 224 sq ft
Gas to Firepit ESTIMATED $ VALUATION 32,000
SWIMMING POOL ® SPA V�, POOL FENCING ❑ DRAINAGE
Check Appropriate box for
FEGilboa AME
rNewport Coast
ENGINEER'S NAMEer
ADDRESS
1201 N. Tustin
CITY
Anaheim
® 5. CONTRACTOR'S NAME
Dreamscapes by MGR
1901 Newport Blvd #350
CITY
Costa Mesa
)FFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
FormslPool spa appl (rev3-o4).xls
Jason
Ca
949.336.0289
3T FIRST
Todd LICENSE NO.
67656
Ca 92807 �--_._...
7147AADDRESS
630.6100
BUSATE LIC
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