HomeMy WebLinkAboutS2022-0062 - Permit Application (2)„kr WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION r n
PLEASE PRINT OR TYPE U V w L
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
41 Bodega Bay
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool Remodel
SWIMMING POOL ® SPA EZ
Check Appropriate box for Annlicant
skimmer, add skimmer, add raised bond beam,
owl a nc q
ESTIMATED $ VALUATION 22.000
POOL FENCING ❑ DRAINAGE
3. OWNER'S NAME LASTF T
Guerena Jon
ADDRESSOWNER'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 1949.295.4611
CE USE ONLY
PERMIT NO. 2022. • 4131% Ttp2Z. • COS L S2 &.V&,n,
PLAN CHECK NO. DWSS 19.DZSL
POOL P/C FEE $
DRAINAGE P/C FEE $
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