HomeMy WebLinkAboutS2020-0195 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION 7,0 ' -Lr
rLenae MINI UK I in
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1 Belcourt Dr
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and
45-b
SWIMMING POOL 0 SPA
Check Appropriate box for Applicant
and pool demo
_ ESTIMATED $ VALUATION 50,000
POOL FENCING ❑ DRAINAGE EZ
❑ 3. OWNER'S NAME LAST FIRST
Gee
ADDRESS
OWNER'S E-MAIL ADDRESS
1 Belcourt Dr
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
714.529.3360
❑ 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
Promontory Pools
No. 404194 Class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
17401 Irvine Blvd #B
CITY STATE ZIP
PHONE NO.
Tustin Ca 92780 1714.508.0557
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
FoonslPool spa appl (mv3-04).xls
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