HomeMy WebLinkAboutS2018-0109 - Permit ApplicationS2-0 1S - 001
0��°"r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
° '�' CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1520 Kings Rd. Newport Beach, CA
LEGAL DESCRIPTION
LOT BLOCK TRACT
2., DESCRIPTION OF
TED
SWIMMING POOL' SPA ❑ POOL FENCING ❑
Check Appropriate box for Applicant
0 3. OWNER'S NAME
LAST
Troesh
FIRS
3
ADDRESS
OWNER'S E-MAIL ADDRESS
1520 Kings Rd.
CITY
STATE
ZIP
PHONE NO.
Newport Beach
CA
❑ 4. ENGINEER'S NAME
LAST
FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
(
rl
CITY
STATE
ZIP
IPHONE NO.
fipahpwl
Ilk
1721�07
1%1y- &1'3°-61cC
IN 5. C NTRA R'S NAME
BUSINESS LICENSE
STATE LICENSE
861880 C-53
Mata Construction Co. Inc
No. Class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
910 E 4th St
CITY
STATE
ZIP
PHONE NO.
Santa Ana
CA
92701
714-393-6358
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL PIC FEE $Q
DRAINAGE PIC FEE $
ForrnslPool spa appl (rev3-04).xls