HomeMy WebLinkAboutS2021-0173 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
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PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1521 Dorothy Ln
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool Remodel- Add 48 sq ft spa, add raised bond beam, raise pool floor
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ESTIMATED $ VALUATION 30000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE ❑
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3. OWNER'S NAME LAST FIRST
McCollum Chad
ADDRESS
OWNER'S E-MAIL ADDRESS -
1521 Dorothy Ln
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92660
949.812.8001
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
Pacific Paradise Pools
No. 522119 Class C5
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
3007 S Harbor Blvd
CITY STATE ZIP
PHONE NO.
Santa Ana Ca 92704
714.437.7665
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
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