HomeMy WebLinkAboutS2021-0182 - Permit Application (2)WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAIUNG ADDRESS)
26 Tidal Surf
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 330 sq ft
as to Ire pit
ESTIMATED $ VALUATION 35000
SWIMMING POOL ® SPA POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
D 3. OWNER'S NAME LAST FIRST
Bahar Ghafouri
ADDRESS
OWNER'S E-MAIL ADDRESS
26 Tidal Surf
CITY STATE ZIP
PHONE NO.
Newport Coast Ca 92657
949.394.9963
❑ 4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Thompson Matt
86051
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
Sunset Pools
iNo473735 classC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
1400 E Katella Ave #217
CITY STATE ZIP
PHONE NO.
Orange Ca 92867 1714.538.4398
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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