HomeMy WebLinkAboutXC2023-0182 - Permit Application°k WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
�87$ Halyard
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Replace decking around existing pool - install equipotential bonding grid
and update drainage ESTIMATED $ VALUATION 6500
SWIMMING POOL ❑ SPA ❑ POOL FENCING ❑ DRAINAGE
A ' t x for A licant
Check ppropna e b
o pp
FIRST
3. OWNER'S NAME
LAs
Newport Knolls
ADDRESS
OWNER'S E-MAIL ADDRESS
874 Halyard
CITY
STATE
ZIP PHONE NO.
Newport Beach
Ca
92660 714.557.6309
4. ENGINEER'S NAME
LAST
FIRST LICENSE NO.
ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY
STATE
ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE LICENSE '
teerra
No.656128 classC53
CONTRACTOR'S EMAIL ADDRESS
ADDRESS
P.O. Box 5489
CITY
STATE
ZIP
NE NO.
Ca
92248
r760.R222
La Quinta
.398
11110
F
USE ONLYERMIT NO.Z LAN CHECK NO. , L " iv
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).rds