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HomeMy WebLinkAboutS2020-0180 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION ra CITY OF NEWPORT BEACH PLEASE PRINT OR TYPE BUILDING DIVISION S2020 •01 so 1. PROJECT ADDRESS (NOT MAILING ADDRESS) LLEGAL DESCRIPTION LOT BLOCK TRAIT 2. DESCRIPTION OF WORKK)PPW F�Ci0L C SWIMMING POOL 1 SPA Check Aoorooriate box for Annliranr _ ESTIMATED M POOL FENCING ❑ lT DRAINAGE 3. OWNER'S NAME LAST FIRST ADDRESS OWNER'S E-MAIL ADDRESS .�5 CITY ..---STATE ZIPII PHONE NO. /�0 z 757--1 4. EN NEE 'S NAME LAST FIRST LICENSE NO. lc(,3 ADDRESS ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. 5. CONTRACTOR'S NAM BUSINESS LICENSE STATE LICENSE 1-661 lAl&jjt,4 (%n 6A f No.WClass ADDRESS COCTOR'SE- fl -ADDRESS CITY STATE I ZIPPHONE NO. X USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ ro"swooi spa apps (rev3-04).xis I bole , 2 W ani