HomeMy WebLinkAboutX2021-3338 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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u CITY OF NEWPORT BEACH X 02I
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
4708 Neptune Ave
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa 240 sq ft
ESTIMATED $ VALUATION 22000
SWIMMING POOL ® SPA ® POOL
Check Appropriate box for ADolicant
Y'S DRAINAGE
3. OWNER'S NAME LAST FIRST
Gassel
ADDRESS
OWNER'S E-MAIL ADDRESS
4708 Neptune Ave
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
714.554.1007
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
Lacher Todd
67656
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
Infinity Pools
No. 891370 CIassC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
28295 Camino Estribo
CITY STATE ZIP
PHONE NO.
Temecula Ca 92590 1714.262.9164
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $ J l
DRAINAGE P/C FEE $
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