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WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION S
F.
CITY OF NEWPORT BEACH
PLEASE PRINT OR TYPE BUILDING DIVISION
1. PROJECT ADDRESS NOT MAILING ADDRESS)
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2. DESCRIPTION OF WORK
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SWIMMING POOL
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box for
BLOCK
TRACT
— ESTIMATED $ VALLIA7
SPA L� POOL FENCING ❑
DDRESS Y 6-7 1/
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DRE/SS �—
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ATE
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DRAINAGE ❑
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ZIP PHONE NO.
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Rsr LICENSE NO.
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TRACTOR S E MAIL ADDRESS 777 Class
ZIP PHONE NO.
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PERMIT NO. Szo Z n? /
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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