HomeMy WebLinkAboutS2020-0162 - Permit ApplicationPLEASE PRINT OR TYPE
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WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH �j�JU �j✓I�U( �i✓���
BUILDING DIVISION
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
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LEGAL DESCRIPTION
LOT BLOCK
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2. DESCRIPTION OF WORK_
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ESTIMATED $ VALUATION ��
SWIMMING POOL SPA
POOL FENCING ElDRAINAG
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3. OWNER'S NAME FIRST
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ADDRESS � �
OWNER'S E-MAIL ADDRESS
CITY' STATE ZIP PHONE NO.
4. ENGINEER'S NAME LAST pIRST LICENSE NO.
ADDRESS ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME /� n �r BUSINESS LICENSE STATE LICENSE
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ADDRESS CONTRACTOR'S E-MAIL ADDRESS
CITY STATE ZIP PHONE N(i[ C�G�
OFFICE USE ONLY
PERMIT �� ��
NO.
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PLAN CHECK NO. j Nu
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POOL P/C FEE $ �'
DRAINAGE P/C FEE $
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