HomeMy WebLinkAboutS2022-0062 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
NF`
BUILDING DIVISION c _ A
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
41 Bodega Bay
BLOCK TRACT
2. DESCRIPTION OF WORK Pool Remodel
SWIMMING POOL ® SPA
Check Appropriate box for Applicant
skimmer, add skimmer, add raised bond beam,
owl and
ESTIMATED $ VALUATION 22.000
POOL FENCING ❑ DRAINAGE
3. OWNER'S NAME LAST FIRST
Guerena Jon
ADDRESS
OWNER'S E-MAIL ADDRESS
41 Bodega Bay
CITY STATE ZIP
PHONE NO.
Corona Del Mar Ca 92625
714.305.6625
❑ 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
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Aqua Scapes Pools and Spas
No. 754729 classC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
321 Calle Felicidad
CITY STATE ZIP
PHONE NO.
San Clemente Ca 92672
949.295.4611
,E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
FormslPool spa appl (rev3-04).)ds