HomeMy WebLinkAboutS2018-0159 - Permit ApplicationTYPE
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
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LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK pcx-� --
C ESTIMATED $ VALUATION
SWIMMING POOL SPA ❑ POOL FENCING ❑
DRAINAGE ❑
Check Appropriate box for Applicant %
3. OWNER'S NAME LAST FIRST e
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
4. ENGINEER'S AMESLA T FIRST
LICENSE NO.
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ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE((
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ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
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CITY STATE ZIP
PHONE NO.
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OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Farms\Pool spa appl (rev3-04).xls
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