HomeMy WebLinkAboutS2022-0184 - Permit ApplicationURI-
VVUKKJntt I rurc FOUL UUMbINATION PERMIT APPLICATION
CITY OF NEWPORT BEACHC /
BUILDING DIVISION J
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
LEGAL DESCRIPTION
LOT BLOCK TRACT
i7 x2q � 3
2.DESCRIPTION OFWORKJf�u�� 9✓l� /cca� �C S/lo�cJ'e��po� Cdo1 SPO1.
Z 495 4(46S ESTIMATED$ VALUATION 0 600
SWIMMING POOL SPA POOL FENCING ❑ DRAINAGE M
Check Appropriate box for Aaalicant
3. OWNER'S NAME LAST FIRST
ADDRESS
I SIw,�, �o ��
OWNER'S E-MAIL ADDRESS
��llyzt` F9aI �, n
CITY r�� (( STATE ZIP
V V+ �J�'gcV� G 7Z6�9
PHONE NO.
9f y-2yZ-,13zz
4. ENGINEERS NAME LAST FIRST
LICENSE NO.
a kiAlOf rv\ ,, /
O /a O,J�/
ADDRESS
A-,�L
ENGINEER'S E-MAIL ADDRESS
C� ( IJ 77,A)
A t a I 'em
CITY STATE ZIP v
PHON NO.
1�t(vv'l T c zo"o-7
17/y_�3o4/16
5. CONTRACTOR'S NAME p /
oelS—�3
BUSINESS LICENSE
STATE LICENSE
No. 41%%d Class
ADDRESS I
11736/ /J/aa/�41�{0S— ��CA
CONTRACTOR'S E-MAILADDRESS1
I'I ,L4-u1
CITY // STATE ZIP
Ct 72 I6y (
PHONE NO.
71y — yz o --S-V 73
USE ONLY
!RMIT NO.
NO
FEE $
1CFE{ E$
spa appl (rev�3-04).xls
pcto22- 2213