HomeMy WebLinkAboutS2021-0093 - Permit ApplicationSZaz1 -
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WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION oQ(�;i
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
233 Morning Canyon
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 448 Sq It
SWIMMING POOL ® SPA
Check ADDronriate hnx fnr Annlirmni
_ ESTIMATED $ VALUATION 45,000
POOL FENCING [I DRAINAGE
E] 3. OWNER'S NAME LAST FIRST
Declark
ADDRESS
OWNER'S E-MAIL ADDRESS
233 Morning Canyon
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92625
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 YllecjS 92807
714.630.6100
® 5. CONTRACTOR'S NAME
Infinity Pools
BUSINESS LICENSE STATE LI ESE
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No. 8913
ADDRESS
0 Ciass
CONTRACTOR'S E-MAIL ADDRESS
555 EI Camino Real #A417
CITY STATE ZIP
PHONE NO.
San Clemente CA 92672
714.262.9164
,E USE ONLY
PERMIT NO. �Z,Ql.� • �q� )
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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