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HomeMy WebLinkAboutS2020-0121 - Permit Application-�. � /e `"�°"�`' WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION 10, 1 _ CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 20201 ORCHID ST, NEWPORT BEACH, CA 92660 LEGAL DESCRIPTION LOT 11 BLOCK TRACT 1500 2. DESCRIPTION OF WORK NEW POOL AND SPA CONSTRUCTION J Sq i ESTIMATED $ VALUATION SWIMMING POOL [A SPA ® POOL FENCING ❑ DRAINAGE Check Appropriate box for Applicant © 3. OWNER'S NAME LAST FIRST RAD ROMIN ADDRESS OWNER'S E-MAIL ADDRESS 20201 ORCHID ST ROMINRAD@GMAIL.COM CITY STATE ZIP PHONE NO. NEWPORT BEACH CA 92660 (949) 9734666 El 4. ENGINEER'S NAME LAST FIRST LICENSE NO. BIEDENBACH CHRISTOPHER 4003 ADDRESS ENGINEER'S E-MAIL ADDRESS 1201 N. TUSTIN AVE. INFO@POOLENG.COM CITY STATE ZIP PHONE NO. TUSTIN CA 82807 (714) 630-6114 5. CONTRACTOR'S NAME �r � STATE C J _ NC -6e Class ADDRESS CONTRACTOR'S E-MAIL ADDRESS 1 L17 �y� p v� ITY STATE ZIP PHO NO. dr�oCv �3= `t C4 �� `l 7 � �7`� VZ OFFICE USE ONLY Solo h r7 i PERMIT NO. `(/ (��(/J�°(��%�� �j PLAN CHECK NO. 1"17011 yV (/`� POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls