HomeMy WebLinkAboutS2019-0044 - Permit Application0588-1901?
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WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
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PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
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Dell
2. DESCRIPTION OF WORK
BLOCK
SWIMMING POOL SPA 6
Check Appropriate box for Applicant
A
TRACT
ESTIMATED $ VALUATION
POOLFENCING-Q DRAINAGE
3. OWNER'S ME LAST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
Cvy
4. ENGINE S NAME LAST FIRST
LICENSE NO.
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ADDRESS
ENGIN ' E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICEENSE
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ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
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CITY STATE ZIP
1PHONE NO.
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OFFICE USE ONLY
PERMIT NO. /q
PLAN CHECK NO.0
POOL P/C FEE $ p��lj` �j „
DRAINAGE P/C FEE $ /'V UrA J `n `'+--'q
Forms\Pool spa appl (rev3-04).xls