HomeMy WebLinkAboutM2008-0007Worksheet tor E3uillding Combo Permit Ap
City of Newport Beach - Building Department PMER RL
se print 3 copies CITY OF NR
V.6uilcling f—.. Grading r—',Drainage Elec F-11 Mech
Project Address (Not mailing address)
C
. ...... . ... .... . . ......
4-
# Units (if Residential)
nant Name(if Applicable)
............................ ..........
Description of Wo
. ..... .. .............. ........... I ............ .............................. ....................... .................................................... ...................
xist House SF Demo House SF use SF
Add/Reconstruct Ho
............... . I ............. ..............
xist Gar SF F777 Demo Garage SF F777 Add/Reconstruct Garage SF F
TOTAL HOUSE SF
New J-7 Add 17. Alter [—..Demo ........... . ..... ...............
TOTAL GARAGE SF
111411 41(t
.......... ... .. ...
.k Appropriate Box for
3. Owner's Name
cant
Last
vner's Address
-----------
. . .. .................. ...... .. ........... ........ V.
........................ -
State
Use F
............
Valuation$
..................
# Stories
Cu Yd Cut
Cu Yd Fill
4. Arch itectJDes ig ner's Name Last First ------ Lic, No
. ...... .. . .. ..... ...........
,x-ri-diect,/Designer's Address Ar_chitet-Vbesigner's E-mail Address
.... ............
5. Engineer's Na
n C-; C, r'S
Address
ty
State-- Zip Telephone
Last First
I ................. ............................. ...........
.......... ............... ......... . .. I ............... .......
..........
State
...... .....
Lic. No.
Engineer's E-mail Address
.............
............. .............
Zip Telephone
.......... .... .... .... .. ... .. ...... ...... ... .......
Lic
6. Contractor's Name Last First . No, lass
F� .. ............ ................. .......... ............................................ 1_1 — F
wwactor's Address Contractor's E,mail Address
. ..............
.. ... .. ...... F .............................. ................................... . . ...... ...................... ..........
. . . .. .... .........
ity State F Zip Telephone
_4
................. ............... 6'?
9FICE USE ONLY ENERGY PIC FEE $
GRADING PIC FEE $
7118107 ELEC/MECH/PLUM PIC
PERMIT NO,
PLAN CHECK NO.
PLAN CHECK FEE $
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-X, PICA, HARBOR RESOURC S DIV.
CITY OF NEWPORT EACH
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dfW--b'V-'ktWP0RT BEAttf
HARBOIR PERMIT
P'"'71`M13STION Is; UVRERY 'GiRAPITED TO COMISTRUCT Awl
MAINTAIN THE FAIIU-2 V fMOVVIN ON' TO" REWL"ZSC vmfmclli
AT TRIF SITE MEW-AYED1.
'11W IiAll P1r'N?--1IT PV.04"'ORT SEACH Ant
ANY S�PECUU. TMS PERNV�
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RIGHTS GIW�11
AND V-115 PLf--.Z'AtT MAV v RE D Tk7
IN ACCORDANCE WtTH VITLE V,11.111
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SPECIAL CONDITIONS:
Corps of Engineers Permit
C Imv, Permit
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Other
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CONSTRUCT AND
-i,
;.. REVERSE HEREOF,
Mt:
TE
HE PROVISIONS 60
93EACH ANI)
Aw.SmCW
.--jw4. THIS PERIM
TEN CONSENT 00
THE cm �r
�P� COUNCIL THE
"am GIv-
--.8MISSIVE ONLY
-ANDYMS P�
CITY COUNCIL
IN AGWRDi%i—
.-AuNrCIPAL CODE.
--�DINATOR
FE -1
CrrY OF NEWOW BFACH
HARBOR PERMAT
PEIMPION S MEBY GRANTEI) TO CONSTRUCT AND
MWAIN THE MCKM SHOWN ON THE RE%fERSE HEREOF,
ff THE SITE INDWATED, WSJECT 70 THE PROWSIONS OF
THE HARBOR POW POLIM OF NEWPOqT BEACH AND
ANY SPECIAL CONDITIONS LISMD HEREON. THIS PERMIT
IS NOT TRIMFERABLE *j'*WTTHE WRITTEN CONSENT OF
THE CITY HARBOR COC*DI OR CITY COUNCIL THE
INKM Gwx UNDER Tftz—"Mrr ARE PEWMSIVE ONLY
AND THIS PERMIT MAY 0: RMKED BY TJK CPY COUNCIL
M AdvoWkOftl.U� %&---nn-- —Ams -6— ^—
AITNO. DATE
TRANSFERRED
MOM.
CITY OF,,�PWPORT BEACH FIRE MARINE DFnARTMENT..
HARBdK - ERMIT APPLICATION (Please print'a,..nformation),
1. Applicant (Property Owner) Address Telephone
X�11�) 0� &2�� Z2��� 2, -Z,�;_ - / -5 a 6)
2. Project Address (Street Address) Harbor Permit Number
3. New Construction evision Maintena
-2 C2 11
4. Fee Check No. 6
5. Brief Description of Proposed
Date
Dredging
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). 1, Any special conditions affecting the construction or affecting boating operations.
10).Complete all information required in information block, bottomof 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.
13j.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'slAgent's Signature: Date: 41-a /,Vf
/Date:
Joint Permittee Signature (if a Iricable):
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)
Site Inspection. (call 644-3043 for appointment)
Site Re -inspection
Conditions:
Date
Date
Date
Date
Date
Date
Date
Date
Date
17,__� -
Date
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).
/ -- 1, 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).
1, 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:
-nat Date�-,6�
Owner's Signature7:
Telephone:
Contracton
Address:
License class: State Board No. City License No.
License Contractor's Declaration
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:
EACH
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CITY OF NEWPORT BEACH
March 21, 1990
P.O. BOX 1768, NEWPORT BEACH, CA 92659-1768
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Each year the City of Newport Beach sends statements to the holders
of pier permits in Newport Harbor notifying them that the annual
pier permit fee is due. Two statements have gone to this address
and have been returned. We conclude, therefore, that the permitee
is not the person or entity shown in our records.
The City Council Harbor Permit Policies state:
10. "Permits for harbor structures are issued subject to the
condition that any improvements constructed shall not be sold in
whole or part, leased, or transferred,. without the written consent
of the City"., and
4.C. "The permit is not transferrable without the written consent
of the City of Newport Beach".
10.D. "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."
We enclose "Instructions for Pier Permit Transfer". Please contact
the Marine Department for further advice on transferring the permit
for a pier, if such be necessary. If we need only make an address
change, please inform us of the correct address to use.
We call attention to the enclosed statement from the Finance
Department of the City.
If you have questions, please call 644-3044.
Sincerely,
Ake,
Tony Me
7m
Tidelands Administrator
3300 Newport Boulevard, Newport Beach
W WESTERN murrUAL ESCROW
M CORPORATION
office Bayside Drive, Newport Beach, Ca. 92663 675-4300
City of Newport Beach.
3300 Newport Blvd. Our Escrow No.
Newport Beach, Co. 44 6158
1500 S. Bayfront, Balboa Island
Dale 10-14-75
Gentlemen:
In connection with the above numbered escrow, we enclose herewith the following:
x)'Check No. 34179 in the amount of $110.00 and pier & float transfer card for your
files. The new owner is CharlesT. Richardson, 320 S. Thomas Street, Pomona, Ca.
91766.
W1
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A*
Vr
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01
Ve7 truly yours
th
Manager as
V.90 I I �B�V!A�l 6eM
14ARINE SAFETY DEPARVIBNT
70 Newport Pier
July 13, 1972
Y
Miss Doris Walker
Western Autual
4 'A'
SSCrOw Department
8ox 1-097
Newport Beach, California 92660
Dear Miss Walker-.
An inspection of the pier* rai,�%p,, and float at 1500
S. Day Front (harbor permit,0225-1500) was made by
th ' e marine Safety Department on July 10, 1972. The
Dier, ramp, and float meet city standards and are
acceptable for transfer.
Sincerely#
(94r$4) LAVerne Pinfrock
Marine Safbty Department