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HomeMy WebLinkAboutS2022-0031 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION } m CITY OF NEWPORT BEACH BUILDING DIVISION PLEASE PRINT OR TYPE 1. PROJECT ADDRESS (NOT MAILING ADDRESS) 1591 Orchard Dr LEGAL DESCRIPTION LOT BLOCK TRACT 2. DESCRIPTION OF WORK Pool and Spa 405 sq ft SWIMMING POOL ® SPA Check Appropriate box for Applicant ESTIMATED $ VALUATION 38,000 POOL FENCING ❑ DRAINAGE ❑ 3. OWNER'S NAME LAST FIRST Fusswinkel Steven ADDRESS OWNER'S E-MAIL ADDRESS 1591 Orchard Dr CITY STATE ZIP PHONE NO. Newport Beach Ca 92660 516.884.0228 ❑ 4. ENGINEER'S NAME LAST FIRST LICENSE NO. Lenehan Kyle 82227 ADDRESS ENGINEER'S E-MAIL ADDRESS 1024 Iron Point Ste 100-1486 CITY STATE ZIP PHONE NO. Folsom Ca 95630 1916.287.1445 ® 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE Premier Pools and Spas iNo.798298 C1assC53 ADDRESS CONTRACTOR'S E-MAIL ADDRESS 26052 Merit Circle #106 CITY STATE ZIP PHONE NO. Laguna Hills Ca 92653 1949.215.4144 :E USE ONLY PERMIT NO. PLAN CHECK NO. POOL P/C FEE $ s 2�0Z2 - 0b,-:; I C� Z-S f-/ - 7—e�Z-Z DRAINAGE P/C FEE $ Forms\Pool spa appl (reQ-04).xls