HomeMy WebLinkAboutS2020-0167 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
T
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1105 Devon Ln
LEGAL DESCRIPTION
LOT BLOCK TRACT
S2020.01('07-
2. DESCRIPTION OF WORK Pool and Spa 350 sq It
ESTIMATED $ VALUATION 35,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
3. OWNER'S NAME LAST FIRST
Tom
Bratz
ADDRESS
OWNER'S E-MAIL ADDRESS
1105 Devon Ln
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
949.230.3746
❑ 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
1714.630.6100
0 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Aqua Scapes
No. 754729 classC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
321 Calle Felicidad
CITY STATE P
ZI
PHONE NO.
San Clemente Ca 92672
949.295.4611
OFFICE VSE ONLY s /� ., /� � L I V^
PERMIT NO. • I
PLAN CHECK NO. Ift. (0th
POOL P/C FEE $
DRAINAGE P/C FEE $
FormsWool spa appl (rev3-04).)ds