HomeMy WebLinkAboutS2020-0206 - Permit ApplicationWORKSHEET FOR POOL
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CITY OF NEWPORT BEACH
BUILDING DIVISION
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
4508 Dorchester Rd
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool remodel. Add baja reef shelf and replaster 360 sq ft
ESTIMATED $ VALUATION 12,000
SWIMMING POOL ® SPA ❑ POOL FENCING ❑
Check Aoproariate box for Aoolicant
DRAINAGE ❑
❑ 3. OWNER'S NAME LAST FIRST
Jacobson
ADDRESS
OWNER'S E-MAIL ADDRESS
4508 Dorchester Rd
CITY STATE ZIP
PHONE NO.
Newport Beach Ca 92625
949.653.3620
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
714.630.6100
® 5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE
Timeless Pools
iNo1019202 ClassC53
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
660 Dundee Ct
CITY STATE ZIP
PHONE NO.
Brea Ca 92821
1714.618.3326
:E USE ONLY
PERMIT NO.
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PLAN CHECK NO.
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POOL P/C FEE $
DRAINAGE P/C FEE $
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