HomeMy WebLinkAboutS2020-0211 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH (?
'141f'IMV`
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
17 Dartmouth
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Spa 80 sq ft
ESTIMATED $ VALUATION 20,000
SWIMMING POOL ❑ SPA ® POOL FENCING ❑ DRAINAGE JZ
Check Appropriate box for Applicant
3. OWNER'S NAME
LAST
FIRST
Sanadiki
Daneia
ADDRESS
OWNER'S E-MAIL ADDRESS
17 Dartmouth
CITY
STATE
ZIP
PHONE NO.
Newport Beach
Ca
92660
949.332.0208
0 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
714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Bret Steele
No. 923975 ciassC53'
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
4921 E Leeds Ave
CITY
STATE
ZIP
IPHONE NO.
Orange
Ca
92867
714.496.1427
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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