Loading...
HomeMy WebLinkAboutS2021-0224 - Permit ApplicationF "p�{°°r WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION \.. �n ...,��, CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 1469 Fc),4 'Rr-.Sf�l c:- LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK Foar + SPA. c>• Li Fra - W l kw .,( ESTIMATED $ VALUATION SWIMMING POOL Lj SPA T?f POOL FENCING © DRAINAGE ❑ 9:1 aWdwN Fel Check Aoorooriate box for Aoolicant o 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. ADDRESS ENGINEER'S E-MAIL ADDRESS L M •t0 vLdcp CITY STATE ZIP PHONE NO., 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE No. looass ADDRESS CONTRACTOR'S E-MAIL ADDRESS CITY STATE ZIP PHONE NO. OFFICE USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ DRAINAGE P/C FEE $ Forms\Pool spa appl (rev3-04).)ls V57QS ^'—