HomeMy WebLinkAboutS2022-0187 - Permit ApplicationWORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
' CITY OF NEWPORT BEACH
BUILDING DIVISIOU,
PLEASE PRINT OR TYPE
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
690 Newport Center Dr
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK Pool and Spa remodel.
ESTIMATED $ VALUATIONp 0000 1 000 -00
SWIMMING POOL ® SPA I] POOL FENCING M DRAINAGE El
Check Appropriate box for Applicant
3. OWNER'S NAME ST FIRST
ADDRESS
OWNER'S E-MAIL ADDRESS
ynv ,VGj Z3o
CITY STATE ZIP
PHONE NO,
N6 CA- 9a4,(,v
q�g-a-:50fOao
4. ENGINEER'S NAME LAST FIRST
LICENSE NO.
.6I edGn bG'cA Carr her
%�1dU'3
ADDRESS
ENGINEER'S E-MAIL ADDRESS
/ 2a/ nJ T sf-ih /;;-
CITY STATE ZIP
PHONE NO.
.,owz v
® 5. CONTRACTOR'S NAME fi$1nr rdC
BUSINESS LICENSE
STATE LICENSE
AQUATIC TECHNOLOGIES — &vvk5
BT97021623
No.744177 classC5
ADDRESS
CONTRACTOR'S E-MAIL ADDRESS
32232 PASEO ADELANTO, STE A
miranda@aquatictechnologies.com
CITY STATE ZIP
PHONE NO,
SAN JUAN CAPISTRANO CA 92675
949-493-9548
'E USE ONLY
PERMIT NO.
PLAN CHECK NO,
POOL P/C FEE $
— D/
10MOZ,- Zz !r5
DRAINAGE P/C FEE $
FormslPool spa appl (rev3-04).xis
��7