HomeMy WebLinkAboutS2018-0051 - Permit ApplicationSD[g_nnq`
(9BUILDING
FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT LI DDRESS)
X20 �LL5/LTvry /V(F v"dGe�)
LOT BLOCK TRACT
2. DESCRIPTION OF WORK
SWIMMING POOL L3 SPA L7
rhark AnnrnnriatP hnx for Annlirant
_ ESTIMATED $ VALUATION 01), `//P
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S NAME LAST FIRST r I
110444 C?E—
ADDRESS
OWNER'S E-MAIL AD ESS
.?Z o r v 1 JeQ Tas✓ A VC
CITY STATE ZIP
PHONE NO.
�V e, ,d p ,/71 �<1,4 - 921;43
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
L /4 rAl 97/.O
ADDRESS
ENGINEER'S E-MAIL ADDRESS
120l A/. -"YS?IAl f1VEA.-VE
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
�A(zZ COOL6 «1 Ci ,
No. lass
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
333 t�A 3Lup
J(M��>+wArz2 xS <! ,AA
CITY STATE ZIP
PHONE NO.
CssST/� fit ` (:2A 2� 2
-j 14 .- 2--+j , ?6<G -S
'E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls
VAPID
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