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S2020-0168 - Permit Application (2)
(a) LOT WORKSHEET FOR POOL C©MBI NATION PERMIT APPLICATION CITY OF NEWPORT BEACH BUILDING DIVISION OR TYPE D (DRESS (NOT MAILING ADDRESS) BLOCK 62021- O iLf t TRACT 2. DESCRIPTION OF WORK FW_� 1w x 654, Irr It// ESTIMATED • ►i/ �i/b SWIMMING POOL m Check Appropriate box for Annlicant POOL FENCING ❑ DRAINAGE ❑ 0 3. OWNER'S NAME LAST FIR T 7;1) f Chrts o� ADDRESS OWNER'S E-MAILADORESS 1Poi?rf - oma .1nive CIT Nelms -� Oeach STATE C/t- ZIP PHONE NO. 4. ENGINEER'S NAME LAST Lacher FIRST Ta)d LICENSE NO. 676.56 ADDRESS ENGINEER'S E-MAIL ADDRESS 17DI IV- Tv--51F(iA AVe CITY Anah&Ifil STATE ZIP PHONE NO. 97Sa? 7/9'-430-61 m 5. CONTRACTOR'S NAME L �7 uc1 cn /�- BUSINESS LICENSE STATE LICENSE W i mz—? No. (Nd Class ADDRESS CONTRACTOR'S E-MAIL ADDRESS pp !1d F. CITY STATE ZIP PHONE NO. :E USE ONLY PERMIT NO. PLAN CHECK NO. ' Ip ® POOL P/C FEE $ DRAINAGE P/C FEE $