HomeMy WebLinkAboutM2011-0056Please print 3 copies
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Department
[7.,Building r- Grading f7.Drainage Elec Mech ;';Plum
Tenant Name(if Applicable)
Suite No
2. Description of Work We
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TOTAL BLDG SF Cu Yd Cut
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Check Appropriate Box for Applicant
OFFICE USE ONLY ENERGY P/C FEE $
GRADING P/C FEE $ FIRE P/C FEE $
PERMIT NO.
PLAN CHECK NO.
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June 27, 2011
West Coast Escrow
Fax 949.721.5010
CITY OF NEWPORT BEACH
829 Harbor Island Drive, Newport Beach, CA 92659
949-644-3044/Fax 949-723-0589
Re: Pier Permit #175-122
122 Via Lido Nord
Escrow # ST -03876 -JM
Dear Mariners Escrow,
The Harbor Resources division has received the completed & signed application
and fee for the pier permit transfer. The pier inspection performed by our office
has determined that it meets City standards.
For further assistance in this matter, please contact this office at 949.644.3044.
Sincerely,
4%sQ A&W
Lisa Walters
Harbor Resources
Jun 23 2011 13:15 P.03
i�.
l
TRANSFER A .L L LATl O V. i
829 Harbox Uland RrivQ
60
S 1\lewp 949=644-D44' 926.........:
**Dat® of Applicatan, 6-17-11 Permit Number: �"J - IZZ
**Property Addr&Ss: 122 'via Lido Nbrd, NeWpat-E Ileacb., Ca 92663
**Buyer's Names: Ano En(3�m sim=
Billing Address: Jul ! y • � `.5
Telephone No_-.
Buyer's Signatures: j
I
"*Seller's Names: L&UFA ASK rEisENBAca AND zucaaIII s, 11MzsEMP
Seller's Signatures:
Joint Owner. Signature: 4
**Escrow Company: WEST COAST ESQRDW Phone#
**Address 140 NEWPORT cEer NERROIRT BEAcg. CA 92660
1eAtFscrow Humber, ST -03876 -SM __**1=aX:#; C949j 7Z1-5010
Closing Date (Estimate): T July 7, 2011
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THf_;pl20CESS_
Inspection Date; ° Reinspection Date:
Fee Paid= r7v Check No: l?7
f
Application Gomplete:�,
HarhorResaurces Si tcrre/C)at®
Special Conditions: This permit is ravocabte by the City Councii
in accordance with TWe f7 of the Newport Roach MUnictpal Code,
i
HARBOR PERMIT
TRANSFER APPLICATION
829 Harbor Island Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton:5/26/2011PermitNumber:
"Property Address: 122 Via Lido Nord
Newport Beach, CA 92663
**Buyer's Names: Anna Berger
Billing, Address:
Telephone No.:
Buyer's Signatures:
**Seller's Names:
Seder's Signatures:
Joint Owner Signature:
West Coast Escrow 949-721-5000
**Escrow Company: Phone#
**Address. 140 Newport Center Dr. #100 Newport
**Escrow Number: ST -03876 **Fax #: 949-721-5010
Closing Date (Estimate): 7/5/2011
y*STARRED ITEMS -MUST BE COMPLETE TO BEGIN THE PROCESS,_
Inspection Date: Reinspection Date:
Fes Paid: Check No: -73
Application Complete:
Harbor Resources Sign a tumlDa te
Special Conditions: This permit is revocable by the City Council
in accordance with Title 97 of the Newport Beach Municipal Code.
Beach, Chi 92660
"', VtjP
H�
June 21, 2011
West Coast Escrow
Fax# 949.721.5010
Re: Pier Permit #175-122
122 Via Lido Nord
Escrow # ST -03876
Dear West Coast Escrow,
CITY OF NEWPORT BEACH
829 Harbor Island Drive, Newport Beach, CA 92659
949-644-3044/Fax 949-723-0589
The City of Newport Beach has inspected the above pier and found it to meet
City standards. Once we receive the application signed by the buyer and
seller the pier will be transferred.
Thanks for your help and if you require further assistance in this matter please
call 949.644.3044.
Sincerely,
l sa W &v
Lisa Walters
Harbor Resources Division
WEST COAST
ESCROW
Date: 5-1� K l
City of Newport Beach
Marine Department
829 Harbor Island Drive
Newport Beach, CA 92660
Attention: Inspector
140 Newport Center Drive #100
Newport Beach, CA 92660
Phone (949) 721-5000 Fax (949) 721-5010
Escrow ## 1 —lJ 77
Please be advised that we have an escrow
12 --� V, i Ot L I
for thre property located at
•
Enclosed please find our check in the amount of $A7 0
00 representing your inspection fee. Kindly complete
your inspection at your earliest convenience, and forward your written report to our office. We in turn will provide
copies to the Buyer, Seller and [teal Estate Agents.
At the close of escrow, we Evill forward the completed pier transfer card to you, along N+ith an additional check for
Please do not hesitate to call if you need any additional information.
Thank you.
ncerely,
�,/�/
Escrow Officer, Manager
� ��i
Harbor Resources Department
Date: [
Inspection Requested By:
Inspector:
,�-``• S
Pier Address: UCL o_r9J
Pier Transfe
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Eelgrass
Reinspection
Yes Need None Needed Yes Need
Date Time F] Eelgrass Within 15' of Project
F] Eelgrass Within 15' - 30' of Project
F] No Eelgrass in Project Area
Pump Out
Pier Location
Yes No
Operational
Recommended Action
Encroachmenet
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Comments / Observations
Other Request
Map Output
Page 1 of 1
http: //www6. city. newport-b each. ca. us/servlet/com. esri. esrimap. Esrimap? S erviceName=n... 06/17/2011
SELLER - SIGN AND RE71URS
HARBOR PERAHT
TRANSFER APPLICATION
829 ]harbor tslanct Drive
Newport Beach, CA 92660
**Date of Aspplicaton: 2/9/05 Permit Number:
'"Property Address: -177 VTA LID NORn
NEWPORT BEACH, OLS 92663
"Buyer's Names: JOE DWIGHT MACPHERSON
Billing Address: 11566 SKYLINE DRIVE
SANTA ANA, CA 92705
Telephone No.:
Buyer's Signatures;
"Seller's Names: JAY
Seller's Signatures:
U AVSD
Joint Owner Signature: 22 a (2nt1>t, --)8aAt
**Escrow Company: MARINERS ESCROW CORPORATION
**Address 1100 NEWPORT CENTER DR. SUITE1200 NEWPORT BEACH, CA 92660
**Escrow Number: 9,go42-RF **Fax #: 94.9-721-8157
Closing Date (Estimate): 3/30/05
*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
.P�.���.+..�.....�.r.ori.���...�...a:.�..�r:��...:.�r�.�or:......erre+.�.►wi�wr�.wiwror..r....r�.
Inspection Date: Reinspection Date:
Fee Paid: Check No:
Application Complete;
Harbor Resources Signature/Data
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
13 R m NN AND RETURN
HARBOR PERAHT
TRANSFER APPLICATION
829 Harbor isla.xid Drive
Newport B e aef t, CA 92660
**Date of Asppliaaton: 2/9/05 Permit Number:
**Property Address: 122 VTA T Tno N RQ n
NEWPORT BEACH, CA 92663
"Buyer's Names: ,,70E DWIGHT MACPHERSON
Billing Address: 11566 SKYLINE DRIVE
Telephone No.:
Buyer's Signatures:
SANTA ANA, CA 92705
"Seller's Names: JAY HARRIS AND MARY ANN BAKER
Seller's Signatures:
Joint Owner Signature:
**Escrow Company:_ MARINERS ESCROW CORPORATION
**Address 1100 NEWPORT CENTER DR. SUITE11200 NEWPORT BEACH, CA 92660
**Escrow Number: 280 7 -BF _ **Fax #: 0,ZEA-8157
Closing Date (Estimate): 3/30/05
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
....�r.....•..,—..---:--..r..---.r-----..,.�.rrr rw......�.�.w..rrrw.r�►rwrw,n�wnn�rr�....�.....•v.
Inspection Date: Reinspection Date:
Fee Paid: Check No:
Application Complete,
Harbor Resources Signature/Gate
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport leach Municipal Code.
9LIFORl"`
February 14, 2005
Mariners Escrow Corp.
Fax 949-721-8157
Re: Pier Permit #175-122
122 Via Lido Nord
Escrow # 28042 -BF
Dear Sirs:
CITY OF NEWPORTBEACH
829 Harbor island Drive, NewportBeach, CA
949-644-3034/Fax 949-723-0589
The City of Newport Beach has inspected the above pier and found it to meet
_City standards. Once we receive the application signed by the buyer, seller
and joint permittee, if applicable, the pier will be transferred.
Thanks for your help and if you require further assistance in this matter, please
call 644-3034.
Sincerely,
LOrr'e Arctse
Lorrie Arcese
Harbor Resources Division
INSPECTION FORM
Harbor Resources Department
Date:
Inspection Requested By:
Inspector: Don Duffy
Pier Address: •' V'/ L, �� ��a,
7S_ -/I-?- a--
(;P;ier;Trans:fer
Reinspection
GFI Present Yes Need None Needed Yes Need
Anti -Siphon / Backflow Present
Other Comments
Eelgrass
Yes No
Present
Pump Out
Pier .Location
Yes No
Operational
Recommended Action
Encroachmenet
Address of Complaining Party.
Boat Description
-.CF Number
Location on Dock
Comments / Observations
Other Request
CITY OF r" =WPORT BEACH FIRE MARINE V`_'1ARTMENT
HARBOk—PERMIT APPLICATION (Please print—cui-'information)
172- Ui6 Ltd 0 0e
1. Applicant (Property Owner) Address Tele hone
2. Project Address (Street Address)
3. New Construction -Revision
4. Fee ��10 Check No.
5. Brief Description of Proposed
Harbor Permit Number
Maintenance_ Dredging
l LP /I Date
6. Submit 8 1/2" x 11" Drawings (3), Include:
1). Location and dimension of proposed structure including piles and location of existing structures.
on adjacent properties.
2). Location of bulkhead, pierhead and project lines.
3). Location of property lines.
4). Location of channel markers within 200 feet.
5). Lot sizes and lot numbers, if available.
6). Existing ground profile beneath proposed structure.
7). Elevation of top and bottom of bulkheads and piles with respect to M.L.L.W.
8). Area and profile of any proposed dredging with elevations showing depths with respect of M.L.L.W.
9). Any special conditions affecting the construction or affecting boating operations.
10).Complete all information required in information block, bottom of sheet. Note that the OWNER.
of the property is the applicant.
11).Drawing size shall be 8 - 1/2" x 11".
12).Scale shall be adequate to clearly show the above information.
13).Existing structures shall be shown in light dashes. New work shall be shown in heavy solid lines.
7. Owner -Builder Declaration must be completed (on reverse side of this sheet)
8. Applicant's/Agent's Signature: -may Date:
Joint Permittee Signature (If applicable): Date:
9. Work can begin once the City has received evidence of the following additional approvals and you have
been notified to proceed. If you begin prior to the notice you will be in violation of the Newport Beach
Municipal Code and subject to penalties.
10. Your permit will not be final until we have conducted an on site inspection once construction is
completed as per Municipal Code, Section 17.24, if we have not been contacted for a final inspection.
OFFICE USE ONLY
Approval in Concept.
Approval of the City of Newport Beach Council.
Approval of the Army Corps of Engineers
Approval of the California Coastal Commission.
Approval of the City's Public Works Department.
Approval of the City's Building Department.
Approval of County of Orange.
Electrical and/or plumbing permit (Building Department)
Issued. (Permit is stamped drawing)
1/ Site Inspection. (call 644-3043 for appointment)
Site Re -Inspection
Conditions:
Date
Date
Date
Date
Date
Date
Date
Date
Date —ea
Dates-/ 7-00
Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the contractor's license law for the following reasons:
(Sec. 7031d.5, Business and professions Code). Any City or County which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires
the applicant for such permit to file a signed statement that he is licensed pursuant to the
provision of the Contractors License Law (Chapter 9, commencing with Section 7000, of
Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty for not more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the
building or improvement is sold within one year of completion, the owner -builder will have
the burden of proving that he did not build or improve for the purpose of sale).
I. as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects who builds or improves thereon, and who contracts for such projects with a
Contractor(s) License pursuant to the Contractor's License Law).
I am exempt under Sec. of Business and Professional Code for this reason:
Owner's Signature:
Contractor:
Address:
License class: State Board No.
License Contractor's Declaration
Date:
Telephone: _
City License No.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
Contractor's Signature Date:
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CRY OF -O
HARBOR
POWAMN IS HEREBY GRANTED TO CONSTR= AND
MAINiAMf THE FACIIJTY SHOWN ON THE REVERSE HEREOF.
AT TIME SItI'E INDICATED, SUBJECT TO THE PROVISIONS OF
THE HARBOR PERMIT POLICIES Of NEWPORT BEACH AND
ANY SPECIAL CONDITIONS LISTED HE9EON. THIS PERMIT
IS NOT TRANSFERABLE WITHOUT THE A' MIFTEN CONSENT OF
THE CITY 14ARSM COORDINATOR oz� tiI T, COUNCIL. THE
WGHTS GIVEN UNDER rAtS PERMIT ,9E 1:? afca tt_ ONLY
AND THIS PERMIT MAY BE REVOKED BY THi
IN ACCORDANCE WITH E T7 OF MLd141cl�".'A . C:
CITY IIA E(R COORDINATOR
PERMIT NO. DATE
fyX411 4-
BUYER'S NAME --
ADDRESS OF FACILITY: PERMIT #
122 Via Lido Nord
MAILING ADDRESS TELEPHONE NO.
-;5Avlt— FEECHECK NO. rE
F2,69
APPROVED BY: DATE APPLICATION IS HEREBY MADE TO TRANSFER HARBOR PERMIT
OCHD ❑ ewitt K McCluggage Jay Harris Baker
ENG ❑ ( e E r
(ABOVE NAMES TO BE TYPE %� _
COUNCIL ❑ x (/ `'
PUBLIC WORKS ❑ SIG T E OF SELLE OF BUY— ER
DEPT. SIGNATURE
ESCROW ❑
SIGNATURE OF SELLER IGNATURE OF BUYER L
INSPECTTION %�: � ?jam �
❑ SIGNATU E OF INTO ER
El APPLICAT O PPR V (D �2
CITY HA SPC 0
SPECIAL CONDITIONS: THIS PERMIT IS REVOCABLE BY THE CITY COUNCIL INA ORDANCE
17 OR THE MUNICIPAL CODE WITH TITLE
CITY OF NEWPORT BEACH, CALIF.
WX Foaw 66-1073 Rev.
}MARINERS ESCROW
CIVIC PLAZA
City of Newport Beach Marine Division
Newport Pier
Newport Beach, CA 92663
Attn: Wes Armand
Re: 122 Via Lido Nord
Enclosed please find the following:
Our check for $163.00 for the transfer fee.
Original signed pier & slip transfer form.
A copy of the letter signed by the buyers from marine division.
4 Civic Plaza, Suite 100
Newport Beach, California 92660
Phone(949)729-0199 Fax(949)729-0190
Date: April 14, 2000
Escrow No.: 2 -1975 -MS
Should you have any questions or need any further assistance, please do not hesitate to contact the undersigned. Thank you.
Civic Plaza
213-5E. ;105
213 589 3105
-EN'S WHOLESALE
178 P02 APR 13 '00 14:55
M Wr "ACM "" AND INARINt DI`PA►RTlV EW
IEltarbirra Mil"
Coldwell AM*W
2t,21 vart Coat Highway,.q1)to
Navrport hm* Ca 926511
Re. Vit Vis Lido Ncwd, pier penttit 17501222
13*w Ms. Mika:
'1111! City of Newport Beach fire am MaritK. nepwMem will AcCLmt a h -w -r
ligowl by Mr- Illy Raker, buyer pf ilte above -M ntrnrted• prolt:rty. +i. hit
Tann"' to ►tM&e the cor"MiOrrs Specified in the lenrr of April ) t).
M&rjmrs t3sat+ow C'urtrr,rmion. Thi+ Irtlat required ttplac ing the cli 0rical
omWU cove[i MW t+epsirs to the surrfiwr oft)w tl M ing duck. -nic letter w
have +wsdirtg to the alf's:tr rbst these tMoin will be doter t:y .luly i S. 7, rtit,til{1
tt3
If you regain: additional infntmafion in rrr:�r6s
t"-3043. to Chia rnattrr. ja4ckurail 949)
Wes Arv=W
KM and Marine 0*@"M=t
The underaigned Jay Harris Baiter and Mary Ann Baker, '1'rastee
Will repair the aurfate of the floating dock and replace the
electrical cutlets covers before the July 15,'2000 date and
reciueai that the• Pier Permit 17501221 be tranuferred to them
i edict�ly up receipt of the transfer form.
1)` i
Jay Harries Baker, Triiatee Mary nn Baker, Trustee
20M00d T 86 ' ON SOTS 68S f: Te < UZd-1d J I f1I J MONDS3 S8aN 16UW 80:2T 00/E Theo
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NEWPORT BEACH FIRE AND MARINE DEPARTMENT
April 12, 2000
Barbara Miles
Coldwell Banker
2121 East Coast Highway, #180
Newport Beach, Ca 92658
Re: 122 Via Lido Nord, Pier Permit 17501221
Dear Ms. Miles:
The City of Newport Beach Fire and Marine Department will accept a letter
signed by Mr. Jay Baker, buyer of the above -mentioned -property, as his
agreement to make the corrections specified in the letter of April 10, 2000, to
Mariners Escrow Corporation. This letter required replacing the electrical
outlets covers and repairs to the surface of the floating dock. The letter would
have wording to the affect that these repairs will be done by July 15, 2000.
If you require additional information in regards to this matter, please call 949-
644-3043.
Sincerely,
�//'o
Wes Armand
Fire and Marine Department
COLDWELL EANKER ID:7147209387
FAx M'-E`'SrSAUl'-`E
COLDWELL BANKER
Fax: (949) 640-8006
Bus: (949) 644-9060 x159
Direct Line.- (949) 718-1559
page I of
To:
Attzi- T 0 PJ Y
Frain: BARBARA MILES
Date: 4/ Time:
Re:
Comments:
H P R 122" ' 00 14:55 Pio .011 P.i'-)l
0 � 5 C-)
6: 4 -
lb
COLD .• BANKER
21-21 East Coast Highway #180, Corona del Mar, CA 92625
PO. Box 8566, Newport Beach, C.A 92658
CCLD,WELL DANKER
RESIDENTIAL BROKERAGE
ID:7147209387 PPR 12' 00 14:57 No.01i P.02
o
d�a
"121 E, COAST HWY, SUITE 180
CORONA DLL IVAR, CA 32625
BUa (949) 644,9060
FAX (649) $40-6006
Indopondently Ownod. And Oporawd By NRT incorporated,
NEWPORT BEACH FIRE AND MARINE DEPARTMENT
April 10, 2000 -
Mariners Escrow Civic Plaza "
4 Civic Plaza, Suite 100 /0�6
Newport Beach, Ca 92660
tD—
Re: Harbor Permit #175-122 for the property at
122 Via Lido Nord, Newport Beach, Escrow #2 -1975 -MS
Dear Sirs:
The City of Newport Beach Marine Department has received a request to
transfer Harbor Permit Number 175-122. The facility was inspected by a
representative of the Newport Beach Marine Division on April 10, 2000.
We cannot transfer the pier permit until the following has/ have been.
corrected and WE HAVE BEEN NOTIFIED OF THE CORRECTION:
1. Replace electrical outlet covers on ramp
2. Float surface broken and uneven.
The Newport Beach City Council Harbor Permit Policies state:
10.1). "At the time of transfer, all harbor structures shall be
inspected for compliance with the City's minimum plumbing,
electrical and structural requirements, and the conditions of the
existing permit. All structural deficiencies must be corrected prior
to transfer of the permit."
PLEASE ADVISE THIS DEPARTMENT WHEN THE ABOVE
DEFICIENCIES HAVE BEEN CORRECTED. Please call 644-3043 to
request a re -inspection.
Sincerely,
Tony Mel
Deputy Chief Marine Environmental Division
I�
MARINERS ESCROW
CIVIC PLAZA
City of Newport Beach Marine Division
Newport Pier
Newport Beach, CA 92663
Attn: Wes Armand
Re: 122 Via Lido Nord
RE: PERMIT #175-122
4 Civic Plaza, Suite 100
Newport Beach, California 92660
Phone(949)729-0199 Fax(949)729-0190
Date : April 6, 2000
Escrow No. :2 -1975 -MS
ENCLOSED A CHECK IN THE AMOUNT OF $165.00 FOR THE DOCK INSPECTION FOR THE PROPERTY 122 VIA
LIDO NORD, NEWPORT BEACH. THANK YOU.
Should you ave any questions or need any further assistance, please do not hesitate to contact the undersigned. Thank you.
Mariners scrow Civic Plaza
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COSTA MESA, 6A 92627
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Order of
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Dollars
Newport Beach Branch #0202
3475 Via Lido R-
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Newport Beach, CA 92663 (714) 973.8495
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CITY OF NEWPORT BEACH FIRE MARINE DEPARTMENT
HARBOR PERMIT APPLICATION
(Please print all information)
C C f (jgao Ste
1. Applicant (Ptooerfy Owner) Address Telephone
2. Project Address (Street Address) Harbor Permit Number
3. New Construction Revision Maintenance Dredging
4. Fee 5 5_7 Check No. / U :) 7 Date q-,7— z --,77
5. Brief Description of Proposed Work:
Rebuild icer /0- (7r s)
o -2 - ; -Alo 410i ,pf u
6. Submit 81/2" x 11" Drawings (3), Include:
1. Location and dimension of proposed structure.
2. Location of bulkhead.
3. Location of property lines and lot size.
4. Location of channel markers within 200 feet of proposed project.
5. Existing ground profile, and area and profile of any dredging with elevations showing depth relative
to MLLW.
6. Elevations of top and bottom of piles and bulkheads with respect to MLLW.
7. Any special conditions affecting the construction or affecting boating operations.
8. Owner Builder/Contractor Declaration/Insurance Information.
7. Owner -Builder Declaration must be co p ed (o r verse side of this sheet)
8. Applicant's/Agent's Signature: Date: �2T"
9. Work can begin once the City has received evidence of the following additional approvals and you have
been notified to proceed. If you begin prior to the notice you will be in violation of the Newport Beach
Municipal Code and subject to penalties.
10. Your permit will not be final until we have conducted an on site inspection once construction is
completed as per Municipal Code, Section 17.24, if we have not been contacted for a final inspection.
OFFICE USE ONLY
Approval in Concept.
Approval of the City of Newport Beach Council.
Approval of the Army Corps of Engineers
Approval of the California Coastal Commission.
Approval of the City's Public Works Department.
Approval of the City's Building Department.
Approval of County of Orange.
Issued. (Permit is stamped drawing.
Site Inspection. (call 644-3043 for appointment)
Site Re -Inspection
Conditions:
Date
Date
Date
Date
Date
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OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the contractor's license law for the following reasons: (Sec.
7031d.5, Business and Professions Code). Any City or County which requires a permit to construct, alter,
improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he is licensed pursuant to the provision of the Contractors License Law
(Chapter 9, commencing with Section 7000) of Division 3 of the Business and Professions Code) or that
he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty for not more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do the
work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and
who does such work himself or through his own employees, provided that such improvements are not
intended or offered for sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he did not build or improve for the
purpose of sale.)
I, as owner of the property, am exclusively contracting with licensed contractors to construct the
project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an
owner of property who builds or improves thereon, and who contracts for such projects who builds or
improves thereon, and who contracts for such projects with a Contractor'(s) License pursuant to the
Contractor's License Law).
I am exempt under Sec. of Business and Professional Code for this reason:
Owner's Signature: Date:
Contractor:7 Telephone:
Address: -30 A/ 0 7-1-66:3
License class _ State Board No. -�,–o a () ? 5 City License No. ® / V %z
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am license"u der provi ' s of Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Pp6fepgions C e an license is in full force and effect.
Contractor's Signature Date: —,)
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PERMISSION IS HEREBY GRANTEE) TO CONSTRUCT AND
MAINTAIN THE FACILITY SHOWN ON THE REVERSE HEREOF,
AT THE SITE INDICATED, SUBJECT TO THE PROVISIONS OF
THE HARBOR PERMIT PouciE3 OF NEWPORT BEACH AND
ANY SPECIAL CONDITIONS LWED HEREON. THIS PERMIT
IS NOTTRANSFERA&.E WITHOUTTHE WRITTEN CONSENT OF
THE CITY HARBOR COORDINATOR CITY COUNCIL THE
RIGHTS GIVM UNDER THIS PERMISSIVE ONLY
AND THIS PERMIT Y BE B THE CITYGfL
IN ACCORDANCE Y i TITLE OF MUNICWM- Mno
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PERMIT NMBRIE
WA71ABLE
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I. TIMBER SHALL BE SEL.
S HOLES S.F. R RECEIVEI A BRUSH COAT OF CONCENTRATED
2. FIELD CUTS AND BORED
ACA OR A
G2A, EC EPDXY COATED OR STAINLESS.
3. BRACKETS AND FASTENERS SHALL BE HOT DIP GALVANIZED, ~
SUCH AS UNPAINTED TIMBER � O
4. WALKING SURFACES SHALL HAVE A SKID RESISTANT AF FINISH,
PROVIDING PROPER
OR GRIT ON TIMBER. v�
5. LOCATION OF PIER, PLATFORM, GANGWAI(,SLIP t3 FLOATS
SETBACKS ARE MAINTAINED. PIER, AND HANGER BRACKET DETAILS.=i�2i'
609-L S 612-L FOR GANGWAY, QEv 4.15.6
6. SEE STD. -604-L, RFv 4- % B=
at: WHERE PIER IS JOINTLY OWNED BY ADJACENT PROPERTIES, P! C,TFOR� WIDTH
MA DATE 3-/- 73
CITY OF NEWPORT TAR
PUBLIC WORKS OE
SINGLE RESIDENTIAL USE
FLOAT WITH PIER
APPROVE —
USLIC WORKS DIRECTOR
R.E. NO. 95
DRAWING NO. 5%D � 6DR � �
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