HomeMy WebLinkAboutS2021-0119 - Permit Application061,
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION S��✓� ®\��
PLEASE PRIM OR TYPE
1. PROJECT ADDRESS (NOT MAIuNG ADDRESS)
1118 Highland Dr
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool Remodel- Add spa and baja shelf to ex. pool 770 sq It
inl1� tsTIMATED $ VALUATION 22,000
SWIMMING POOL ® SPA 0 POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
E] 3. OWNER'S NAME LAST FIRS
Muir Jason
ADDRESS
OWNERS E-MAIL ADDRESS
1118 Highland Dr
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92657
617.461.7978
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
714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Aqua Scapes Pools and Spas
o. 754729 class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
321 Calle Felicidad
CITY STATE ZIP
PHONE NO.
San Clemente CA 92672
949.295.4611
:E USE ONLY — � � 1 f ^� fp,
PERMIT NO. �?j(jZ I 0 U
PLAN CHECK NO. V " LI f J 1
POOL P/C FEE $
DRAINAGE P/C FEE $
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