HomeMy WebLinkAboutS2022-0027 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION r`7
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CITY OF NEWPORT BEACH
BUILDING DIVISION �\N-r-r/v7,e,
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
11 Via Burrone, Newport Coast, CA, 92657
LEGAL DESCRIPTION
LOT 473 BLOCK 032 TRACT 05
2. DESCRIPTION OF WORK Pool and Spa Re -Plastering Permit
SWIMMING POOL EN SPA ❑
Check Appropriate box for Applicant
ESTIMATED $ VALUATION $10,000
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S NAME LAST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
® 5. CONTRACTOR'S NAME
Iconic Development
BUSINESS LICENSE
BT30074490
STATE LICENSE
No. Class ass B
ADDRESS
10073 Valley View St., #272
CONTRACTOR'S E-MAIL ADDRESS
babghari@icloud.com
CITY STATE ZIP
Cypress CA 90630
PHONE NO.
562-277-2456
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).x1s
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