HomeMy WebLinkAboutX2018-1266 - Permit Application (2)(4)
PLEASE PRINT OR TYPE
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATIONCITY OF
(� Ak N, BUILDING DIVISION CH 00"1-111NO
I 1. F'KUJLG I AUUKL56 (NOT ]WAILING ADDRESS)
4527 Perham Road, Corona Del Mar, CA 92625
LOT BLOCK
TRACT
2. DESCRIPTION OF WORK New pool and spa construction in vault
ESTIMATED $ VALUATION 53,000
SWIMMING POOL ® SPA ® POOL FENCING ❑
Check Appropriate box for Applicant
DRAINAGE ❑
® 3. OWNER'S NAME LAST FIRST
The Monifar Revocable Living Trust
ADDRESS
OWNER'S E-MAIL ADDRESS
16951 Armstrong Ave
CITY STATE ZIP
PHONE NO.
Irvine CA 92606
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Pool Engineering, Inc. Lacher Todd
67656
ADDRESS
ENGINEER'S E-MAIL ADDRESS
j1201 Tustin Ave
toddl@pooleng.com
Ir CITY STATE ZIP
PHONE NO.
Anaheim CA 92807
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Villa Pools, Inc.
BT30051925
No. 1004609 classC5
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
17853 Santiago Blvd., Suite 107-302
-
Ibt@villapoolsinc.com
CITY STATE ZIP
PHONE NO.
Villa Park CA 92861
714-488-7563
,E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
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DRAINAGE P/C FEE $
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