HomeMy WebLinkAboutX2018-0101 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
' CITY OF NEWPORT BEACH 0 1 ~l
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
4615 ORRINGTON ROAD, NEWPORT BEACH, CA. 92625
LEGAL DESCRIPTION
LOT 68 BLOCK TRACT 3357
2. DESCRIPTION OF WORK POOL AND SPA - APPROX. 270 SQ. FT.
VALUATION 150,000
( - . FT.
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE ❑
Check Appropriate box for Aoalicant
❑ 3. OWNER'S NAME LAST FIRST
MALONE MICHAEL
ADDRESS
OWNER'S E-MAIL ADDRESS
4615 ORRINGTON ROAD
CITY STATE ZIP
PHONE NO.
NEWPORT BEACH, CA. 92625
949.493.4374
Fj 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
POOL ENGINEERING, INC.
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1701 N. TUSTIN AVE.
CITY STATE ZIP
PHONE NO.
ANAH E I M CA 92807
714.630-6100
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
DEVORE POOLS & SPAS
BT97026761
No.401549 Clas
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
PO BOX 828
devorepools@cox.net
CITY STATE ZIP
PHONE NO.
SAN JUAN CAPISTRANO CA. 92693
949.493.4374
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls