HomeMy WebLinkAboutS2022-0111 - Permit Application„P,o rrr�i
WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
1111 Cliff Dr
LEGAL DESCRIPTION
LOT BLOCK
TRACT
S
2. DESCRIPTION OF WORK Pool and Spa 336 sq ft
ESTIMATED $ VALUATION 40,000
SWIMMING POOL ® SPA ® POOL FENCING ❑ DRAINAGE
Check Appropriate box for Applicant
Conwell
Gary
ADDRESS
OWNER'S E-MAIL ADDRESS
1111 Cliff Dr
CITY
STATE
ZIP PHONE NO.
Newport Beach
Ca
92663
[:] 4. ENGINEER'S NAME
LAST
626.664.0699
FIRST LICENSE NO.
Lacher
Todd
ADDRESS
67656
ENGINEER'S E-MAIL ADDRESS
1201 N. Tustin Ave
CITY
STATE
ZIP PHONE NO.
Anaheim
Ca
92807
® 5. CONTRACTOR'S NAME
714.630.6100
LICENSE STATE LICENSE
Alderete Pools
:BUSINESS
ADDRESS
Nc83 6O2 Class C
CONTRACTOR'S E-MAIL ADDRESS
63 Via Pico Plaza #447
CITY
STATE
ZIP PHONE NO.
San Clemente
Ca
92672 949.492.7289
OFFICE USE ONLY
PERMIT NO.
PLAN CHECK NO.
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POOL P/C FEE $
DRAINAGE P/C FEE $
Formsftol spa appl (rev3-04).xls