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HomeMy WebLinkAboutS2020-0108 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION > CITY OF NEWPORT BEACH $10dfur �O'ov BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 2. S 0 LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK ESTIMATED $ VALUATION SWIMMING POOL ❑ SPA X POOL FENCING ❑ DRAINAGE ❑ Check Appropriate box for Applicant 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. e' l Kr+o (L 09 o, � ��� ADDRESS i ENGINEER'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE C'_' T vLG No. 1 �� lass ADDRESS CONTRACTOR'S E-MAIL ADDRESS r� -- i' q cl L CA-) V y V' CITY STATE ZIP PHONE NO. Y_ �) "r) L, 0 �& U �� PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).xls