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HomeMy WebLinkAboutM2010-0001Worksheet for Building Combo Permit Application 0111PRIUM City of Newport Beach -Building Department Pleasb , print . t 3 copies HARBOR RESOURC ..,Building !Grading F -Drainage r_1 Elec 7- Mech CKE NEWPORT 1. Project Address (Not mailing address) . ...... . . . .. . . ............ .. ..... .. . .. . . .. . .... . ... . .. Tenant Narl Applicable) # Units (if Residential) . . ........... ... ..... . . . ............. 2. Description of Work Use 0 ................ Zv ... ...... e ............... S.+C( ... ... ...P.I.all . ...... ...... ..... ao Ext g Building SF Demo Building SF 1:71 Add/Reconstruct Bldg 3F Valuation Extg Gar sf 17:1 Demo Garage sf Add/Reconstruct Garage sf # Stories F. 17. Add [—j Alter TOTAL BLDG SF Cu Yd Cut New F.Demo Xin,-ta (n.+ TOTAL GARAGE SF Cu Yd Fill [.7 3. Owner's Name Last First ............. Owner's Address CityFA/ State Owner's E-mail Address Fc_(aa C, q 6,? o 61 �o( ... . .. . 1N.; ....... .. .............. -3 Zip r Telephone 3q7 F_. 4. Architect/Designer's Name Last i First Lic. No. Architect/Designer's Address . ... . ...... .. . .. .... . ..... .......... ........ ..... ... .... ... Cityr State F -77 Architect/Designer's E-mail Address .......... Zip Telephone[ - 5. Engineer's Name Last q First Lic. No. F771 Engineer's Address ........... ............. City State ..................... .............................................. Engineer's E-mail Address .... . ......... ........ ..... ..... ..... ............ ...... . ................ ... __ ........ .................... Zip I .. . .... . .. . ..... ... .. .. Telephone[ . ...... ..... ... ............... .. .. F-6. Contractor's Name Lastr DWf78Y First Lic. No, Class i F777777 Contractor's Address .... ...... ......... ... .......... ........... . - ........... ............................. . ....... City State 11.1.11 ........... i OFFICE USE ONLY ENERGY P/C FEE $ GRADING P/C FEE $ 0—, A / 19 mo rl f:(`,/MFCH1PI I IM PIC. FFr % FIRE P/C FEE $ Contractor's E-mail Address .. . ..... .............. . ... ..... .......... ...... .............. ... ... . Zip Telephone��� . ................. .......... . PERMIT NO PLAN CHECK NO. 10 P1 AN (.HP:(.K FFF % _ - n vxyCY�y m!+ss+-vv4u w�-�R}}m/ '_.<,. ..�.. evxi'i" `+✓'uisVr`: i J Sa' 111 4 !{ rte v 7 l 112 9' if 62 *`41 7pr r^"R(:l ls4� ra rzF fi K` '! i' f T Y ,f G.. a �c+yv,s"ra C t1a11r3✓rv,`I+#}P,+ a t� �tr,J"��~t P n Y F _.� r y�t vr-r !^`s v. .✓S, poi !a itt^udr.xs �ro-�"'�a"� P �'S'�ai x 3 ,.v�,.,� n k v •T A e s� 5 :'r 9 ce x xP e r { Or, � 'G... . . re+?.Y yc3 J� w ii"h MA �aR RU DIS � � OF NE W ORT �fAC . 11 . Worksheet for Building Combo Permit Application 2 WaoRr City of Newport Beach Building Department Please prom copies eac- eparHARBOR RESOURCES D j Building F.. Grading j Drainage j Elec j 1. Project Address (Not mailing address) ao r Tenant Name(if Applicable) 2. Description of Work Extg Building SFI Demo Building SF Add/Reconstruct Bldg SF i E.............................................................. Extg Gar sf Demo Garage sf Add/Reconstruct Garage sf TOTAL BLDG SF F New (' _; Add Alter (:Demo- tyt TOTAL GARAGE SF # Units (if Residential) Use Valuation $ SOCIO. Cu Yd Cut Cu Yd Fill # Stories.171 F. 3. Owner's Name LastFirst ........ -SCI-p}$...... .. .......... i�%l:klz Owner's Address tealbfvel. ........... ......_.........._.._......... ....................._: City ME'wport State Owner's E-mail Address CQ (�96`� �ZU� Corn ......... Zip [(?2 ,(0 j Telephone (,p2 / ?7 4. Architect/Designer's Name Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address I ........... ........ .............................................. .... .... .... _... .... ..... ......................... ........ ....................... .... ......... .... _.._.............. City Stat ei Zip Telephone F77 5. Engineer's Name Last._.W First W Lic. No. 177 Engineer's Address ......... ....................................__.........................................-....... ..............................._ City State (� Engineer's E-mail Address ........ Zip [77:_77Telephoned F', 6. Contractor's Name Last C) tNl I er First Lic. No. ..... Class n....M) Contractor's Address ...... v... . ..... ... .- Cit State OFFICE USE ONLY ENERGY PIC FEE $ GRADING P/C FEE $ FIRE P/C FEE $ n,... nn c/nn FI Fr:/MPf:H/pl I IAA p1r. FFF.PR Contractor's E-mail Address .....,,,,... ..... ........................ Zip Telephone PERMIT NO. PLAN CHECK NO. PI AN r:HFC.K FEF_ $ s Worksheet for Building Combo Per iORCES a^ City of Newport Beach - Building Dep U Pl ase >^rinx.3 copies CITY OF NEWPORT BE Building r Grading """Drainage Elec (� Mect _Q,Pl j g 4 1. Project Address (Not mailing address)Mte NO /../......................s,G...�.a............. 0S.e................ 1t1. -.-.............:.z/ ....... .............. ....... ................ # Units (if Residential) Tenant Name(if 2. Description of Work Use f �.._/.1,.��4.C�'........`._L/a r�/...........................,..................... ....... ,....... ,.....,,,.....,.......,... Valuation . $ Exist House SF Demo House SF Add/Reconstruct House SF ---------•- ---i Exist Gar SF Ire Demo Garage SF j( Add/Reconstruct Garage SF # Stories TOTAL HOUSE SF Cu Yd Cut New Add Alter Demo r Li F. - + GARAGESF "heck Appropriate ttox tor Hppucam F—.. 3. / 3. O's Name Last First w;q j— 5. Engineer's Name Last�x Cu Yd Fri First Lic. No. y� Engineer's Address �+ Engineer's E-mail Address .......k' ri (...X4 14.i../_.L.c...._.//..!%:'�l�.........1..1...�..z-dc� ..... /. ........ City I �1 State L/p� Zip © t,-7. Telephone JQ lr '/� if�2 6. Contractor's Name Last First Lic. No. Class- Contractor's Address Contractor's E-mail Address City, /`may, t State (G� Zip (` l6 a Telephone q �Z9�( �-�W.5`�✓......Z...'......................................................! 1..................................l 7. ��li�—._ OFFICE USE ONLY ENERGY P/C FEE $ GRADING PIC FEE $ Rev 1/18/07 ELEC/MECH/PLUM PIC PERMIT NO. PLAN CHECK NO. PLAN CHECK FEE $ bt M X PROJECT ,32' 7728 E BALBOA BL VD NEWPORT BEA CH, CA I I SITE PLAN mwvc=NTH ADAMS SCALE I"--10' V-) 1128 Em BALBOA BLVD, NEWPORT BEACH, CA CONTRACTOR L3ULKHEAD LINE J_ ' i ( — EXISTING DOCK TO REMAIN NO CHANGE — REMOVE AND 1 INSTALL NEW 12" PILEL1 L1 EXISTING GANGWAY TO REMAIN NO CHANGE EXISTING PIER TO ;REMAIN NO.CHANGE PtERHEAD LINE J I � W I L1 Li ow, 10. 4 I REMOVE AND p . INSTALL NEW I o q zl 12" PILE z o } , 12 I~ �u L3ULKHEAD LINE J_ ' i ( — EXISTING DOCK TO REMAIN NO CHANGE — REMOVE AND 1 INSTALL NEW 12" PILEL1 L1 EXISTING GANGWAY TO REMAIN NO CHANGE EXISTING PIER TO ;REMAIN NO.CHANGE v 11P- 112? U- V 11 v 11P- 112? 1 /FAY 1; A yam. 1 n � i 1 - i i !" C <: it A- 9d 11 ?1t v. F•Uai Pta. 1 /FAY 1; A yam. 1 n � i 1 - i i !" C <: it A- 9d J. BERT CITY ENE M Mr. Hugh Adams 107 Pearl Avenue Balboa Island, California Dear Biro Enclosed in duplicate please find. Pier .Permit No. A-905 to construct a pier and float bayward of Lot 15, Block 17, Fastsid.e Addition to Balboa Tract. Your attention is called. to Paragraph IV of the general provisions which provides that this office be notified of the date of the beginning and the date of completion of the work. Would you kindly execute both copies of the permit and. return them to the office of the City Clerk for certifi- cation. A copy will be returned to you for your files. ery t ;K y��oujjr : J B. Webb ity Engineer JBI00bm TELEPHONE HARBOR 9131