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HomeMy WebLinkAboutS2019-0103 - Permit Applicationvp O vay �.4 Mt4M� PLEASE PRINT OR TYPE 6 A"Few iL DESCRIPTION 11.51 2. DESCRIPTION OF WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION T� CITY OF NEWPORT BEACH BUILDING DIVISION G ADDRESS) BLOCK SWIMMING POOL SPA �7r! Check Appropriate box for Applicant /�37 TRACT 13c�s-,2o/9 S,2019.0d03 .� r ■ DRAINAGE■ Ef 3. OWNER'S NAME LAST FIRST cSPP41 I Afly—�– -4 Ebl2/¢S€77� ADDRESS OWNER'S E-MAIL ADDRESS /2-0& 9>/P k/67 1ALbtfA-mll4- prltqgomi�tL- cog CITY STATE ZIP PHONE NO. Hfl9-C-ff C?1- On) - �/ 7 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. 0-1�5-CONTRACTOR'S NAME BUSINESS LICENSE TATE LICENSE �fo Alh1v 6PM (TH fo00LS' -i' Ce TNo.�7!(6 ClassPSl ADDRESS CONTRACTOR'S E-MAIL ADDRESS W. cAF-LE-roN a4VE= �>}il . A-5e-lE-m(-(Ore ftE#l-NSM.q CITY STATE ZIP PHONE NO. D��rNG� cA 2s,(0-7 1(711+�q4F-,�53771 :E USE ONLY PERMIT NO. PLAN CHECK NO. (w- 2c L� POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls S.0; E m