HomeMy WebLinkAboutS2021-0161 - Permit ApplicationE""w°°Rr WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
„w,=a CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
726 Bison Ave
LOT
BLOCK
2. DESCRIPTION OF WORK New pool and spa
TRACT
O
ESTIMATED $ VALUATION $123,000
SWIMMING POOL ® SPA ® POOL FENCING ❑
(`hnrlr Annrnnriata hnx fnr Annlirant
DRAINAGE
3. OWNER'S NAME LAST FIs
q � j
J
l/ 1/ W �d 6I q
ADDRESSOWNER'S
E-MAIL ADDRESS
CITY STATE ZIP
PHONE NO.
❑ 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS F, a /
CITY STATE ZIP
PHONE NO.
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Cruz
BT30075824
956568 C53
.lose
No. Class
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
2211 E Winston Rd
arlene@angelspoolsinc.com
CITY STATE ZIP
PHONE NO.
Anaheim CA 92806
562-335-0119
'E USE ONLY
PERMIT NO,
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3.04).xls
O to z0 -- 011 �
SSS