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HomeMy WebLinkAboutS2022-0102 - Permit Application_S Zo 2 Z - p.0 2- Wa t4mo WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION U��ar CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) --� 8 Windsor LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK REPLASTER POOL & REPLACE TILE SWIMMING POOL ® SPA Check Appropriate box for Applicant \, REPLACE DRAIN COVERS, _ ESTIMATED $ VALUATION $22,371.00 POOL FENCING ❑ DRAINAGE ❑ 3. OWNER'S NAME LAST FIRST Lee Nancy ADDRESS OWNER'S E-MAIL ADDRESS 8 Windsor nancylee14@att.net CITY STATE ZIP PHONE NO. Newport Beach CA 92660 (714) 343-2573 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP . PHONE NO. 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE PAUL WILLIAMS C53 C61 D51No. 571196 Class ADDRESS CONTRACTOR'S E-MAIL ADDRESS 227 W CARLETON AVE PAUL.WILLIAMS@ALANSMITHPOOLS.COM CITY STATE ZIP PHONE NO. ORANGE CA 92867 714-423-0179 :E USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ SZ-czz-oIUZ I I q G -Za zZ Forms\Pool spa appl (rev3-04).xls