HomeMy WebLinkAboutS2019-0130 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
CITY OF NEWPORT BEACH
BUILDING DIVISION
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1. PROJECT ADDRESS (NOT MAILING ADDRESS)
LEGAL DESCRIPTION
2. DESCRIPTION OF WORK
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SWIMMING POOL ❑
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Check Appropriate box for Analicant
TRACT
ESTIMATED $ VALUATION
POOL FENCING ❑ DRAINAGE ❑
3. OWNER'S ME ME LAST FIRST
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ADDRESS
OWNER'S E-MAIL ADDRESS
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PHONE NO.
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4. ENGINEER'S NAME T FIRST
LICENSE NO.
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ADDRESS
ENGINEER'S E-MAIL ADDRESS
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CITY STATE ZIP
PHONE NO.
5. CONTRACTOR'S NAME
BUSINESS LICENSE
STATE y LICENSE
ee
No.
ADDRESS
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CONTRACTOR'S E-MAIL ADDRESS
CITY STATE ZIP
IPHONE NO.
:E USE ONLY
PERMIT NO.
PLAN CHECK NO.
POOL P/C FEE $
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DRAINAGE P/C FEE $
Forms\Pool spa appl (rev3-04).xls