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Worksheet for Pool Combination Permit Application
Please print 3copies City of Newport Beach�^ O'� O'�q 0" as
Building Department L
1. Project Address (Not mailing address)
323 DRIFTWOOD, NEWPORT BEACH, CA. 92625
Legal Description Lot 31 _ Block—
Tract 1116
2. Description of Work
Estimated
Valuation $
50000
SHOTCRETE SPA approx. 110 sq. ft.
F- Swimming Pool r Spa r Drainage
r-, Pool Fencing
Check Appropriate Box for Applicant/Notification Information
r 3. Owner's Name Last McELROY FirstSARAH
Owner's Address Owner's E-mail Address
4720 CORTLAND DR.
City CORONA DEL MAR State CAZip 92625 Telephone F949 422
r 4. Engineer's Name Last POOL ENGINEERING First License No a�3;
Engineer's Address Engineer's E-mail Address
1201 TUSTIN AVE. toddl@pooleng.com
City ANAHEIM StateCA Zip 92807 Telephone 714 630 6100
r 5. Contractor's Name Last DEVORE POOLS & SPAS First I License No.401549
Contractor's Address
PO BOX 828
Contractor's E-mail Address
devorepools@cox.net
City SAN JUAN CAPISTRANO State CA Zip 92693 Telephone 949.493.4374
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
PERMIT NUMBER
PLAN CHECK NO
POOL P/C FEE $
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