HomeMy WebLinkAboutS2020-0188 - Permit Application9 WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
5,20,20•0/88
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1830 Highland Dr
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 288 sq It
Gas and Electric to bbq and fire pit ESTIMATED $ VALUATION 40,000
SWIMMING POOL 2 SPA ® POOL FENCING ❑ DRAINAGE ❑
(thnrir Anmmnriato hnY fnr Annlicant
3. OWNER'S NAME LAST FIRST
Rothbard
ADDRESS
OWNER'S E-MAIL ADDRESS
1830 Highland Dr
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
949 320.0897
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Thompson Matt
86051
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
1714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Promontory Pools
No. 404.194 ClassC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
17401 Irvine Blvd #B
CITY STATE ZIP
PHONE NO.
Tustin Ca 92780
1714.508.0557
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls
?� oN4,01offii