HomeMy WebLinkAboutS2018-0208 - Permit ApplicationZ 019�67 -- O 14D'57
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK_ iU\N FOOk al SPA b° at ---ow ground ( Iia )( T.4")
ESTIMATED $ VALUATIONS "1 V % 0-OOw
SWIMMING POOL N SPA [9 POOL FENCING ❑ DRAINAGE ❑
cnecK Appropriate box for Applicant
3. OWNER'S NAME
LAWFIRST
PERMIT NO.
�?nan
ov/w
ADDRESS
2 l? �� >
b
OWNER'S E-MAIL ADDRESS
4545 ?erNam 7-n
I v
DRAINAGE P/C FEE $
CITY
STATE
ZIP
PHONE NO.
COYO)a GEED may
CA
gz1,29
quq• b31 , b30
4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
Pool ev)QmeQrtY\q IY�c..
LQM Py
Tadd
C 6'1656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N lvsfi Aw
CITY
STATE
ZIP PHONE NO.
A y1A be 1YY1
a .
g2`b0"1 "ll y . tpw, . 141 ()o
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICENSE
LgYlds Cale twvc
G f 1�T`l°ll O 1140-172$1.�WoLnl ClassC2
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
20802
cowl
CITY
STATE
ZIP
PHONE NO.
titinhY, fin p�egch
PiA•
q2�y,�
41bb.0601
CE USE ONLY
PERMIT NO.
PLAN CHECK NO.
2 l? �� >
b
�
POOL P/C FEE $
I v
DRAINAGE P/C FEE $
rmwmrvvi spa apps revs-u4J.ms �
VZ -`)17 - n gCL:S