HomeMy WebLinkAboutS2021-0194 - Permit Applicationo`' PMWrI'k y\i WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH(GA
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAIUNG ADDRESS)
22 Shoreridge
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 464 Sq Ft
ESTIMATED $ VALUATION 45,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE
Check ADorOorlate box for Annlirrant
E] 3. OWNER'S NAME LAST IRsr
Woodgrift Randy
ADDRESS
OWNER'S E-MAIL ADDRESS
22 Shoreridge
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92657
949.299.8021
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Biedenbach Chris
74003
ADDRESSENGINEER'S
E-MAIL ADDRESS
1201 N_ Tustin Ave
CITY STATE ZIP
PHONE NO.
Anaheim Ca 92807
714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE STATE LICENSE
Bret Steele
No. 923975 Clas 53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
4921 E. Leeds Ave
CITY STATE ZIP
PHONE NO.
Orange Ca 92867
714.496.1427
CEUSEONLY cs rc( �I
PERMIT NO. �{ ,
PLAN CHECK NO. ((K4
I 4 � Wy
POOL P/C FEE $
DRAINAGE P/C FEE $
ruonsrom spa apps (re%r,L-m).Xls