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HomeMy WebLinkAboutS2018-0137 - Permit Application`RKSHEET FOR POOL COMBINATION PERMIT APPLICATION 181112 `1018 CITY OF NEWPORT BEACH 5201$"0137 BUILDING_ DIVISION MAILING ADDRESS) 2 P r7fec>,✓G 144 c€ BLOCKZ14) TRACT ION OF WORK iV(--,,i nO spq YkQ� /� `FESTIMATED $ VALUATION Tya DDD MMING POOL SPA [fl-' POOL FENCING ❑ DRAINAGE Check Appropriate box for Applicant 3. OWNER'S NAME LAST FIRST 6/z on -r C S ADDRESS OWNER'S E=MAILADDRESS l8�7 �vr-� .T7-,/zLiNG PL .acs ✓er��y� ;s's,��'! f�.v�l�o r CITY STATErGYLI P14 ZIP PHONE N 41/t'r✓/O v✓% D'c��4cA , CLI . 512Liv r%'Q L 742-5 75" E] 4. ENGINEER'S NAME LAST FIRST L; < L} !-f E/C � LICENSE NO. TVIPP C-Co'74,S ADDRESS ENGINEER'S E-MAIL ADDRESS 12ol N, rvxrlr✓ 4 VE e / CITY Cl VV/fin q, ro� ,4 A/A L% Ej *r STATE ZIP PHONE NO. ✓ c -,49'Z 7 71V L386 -),6L) 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE .rcyw,eiRZ I�e�cLS X6732 5 No. C" ADDRESS - S3 J 3 DJ r7 CONTRACTOR'S E MAIL ADDRESS Class J % F/ �L L/J � ����� St � Wii l'��✓ t7p1J'a (�'/Yf CITY STATE f'B r-4 /��Jd ZIP PHONE NQ. is 6z 6 �l� 9 P72 D�s'v OFFICE USE ONLY PERMIT NO, - ZD RD PLAN CHECK NO. POOL P/C FEE $ _. DRAINAGE P/C FEE $ FormslPool spa apPI (rev3-04).xls 17,0 6