HomeMy WebLinkAboutS2021-0231 - Permit Application4°0eg y WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH S20Z,k-02--51
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1 Secret Cove
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK 40 sq ft Spa - Gas to fire
SWIMMING POOL ❑ SPA FZ
Chpck Annronriate box for Anolicant
_ ESTIMATED $ VALUATION 22,000
POOL FENCING ❑ DRAINAGE
3. OWNER'S NAME LAST FIRST
Sieger Greg
ADDRESS
OWNER'S E-MAIL ADDRESS
1 Secret Cove
CITY STATE ZIP
PHONE NO.
Newport Coast Ca 92657
949.315.1814
13 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Biedenbach Chris
74003
ADDRESS
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
1714.630.6100
[15. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Western Pavers
No. 592071 class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
1210 Barham Drive
CITY STATE ZIP
PHONE NO.
San Marcos Ca 92708
1760.566.5678
'E USE ONLY
PERMIT NO.IS Il u 1hU' U
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa app] (mv3-04).)ds