HomeMy WebLinkAboutS2021-0206 - Permit Applicationrvm rUUL COMBINATION PERMIT
`v„LG' CITY OF NEWPORT BEACH APPLICATION �� �
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PLEASE PRINT OR TYPE BUILDING DIVISION
1.-P-- RODECT—ADDRESS (NOT MAILING ADDRESS)
19-6 U �s �-( i1rf,�vlc.el b h Cc ✓-
LEGAL rIFSRRIorinni
BLOCK TRACT
2. DESCRIPTION OF WORKe
SWIMMING POOL R SPA
,-necK Appropriate box for Applicant
3. OWNER'S NAME �5-
'�?-C-S1L �1�!
ESTIMATED $ VALUATION-( O
POOL FENCING
DRAINAGE ❑
ADDRESS
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CITY
F
STATE
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4. ENGINEER'S NAME
LAST F
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�Vle LIV
Pn^
^7ADDRESS
CITY
STATE
ADDRESS
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CITY STATE
CA —
OFFICE USE ONLY
q91q7 "m11
C(2111-1 $c-1`71`A 6,31-G(OO
ZIP PHONE NO.
`�Z663 � —
PERMIT NO. �!yel
PLAN CHECK NO. �G
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls