HomeMy WebLinkAboutM2009-0007Please print 3 copies
Worksheet for Building Combo Permit Application
City of Newport Beach - Building DepartnwBOR RES(
ilding Grading
1. Project Address (Not mailing address)
7,05- &d4iO
01
Tenant Name(if Applicable)
..............
2. Description of Work
M
F. -Drainage F-, Elec r
Exist House SF
Exist Gar SF
F7,. New F7 Add
. I—
MA� kf*- kjll�
Demo Garage SF F777 Add/Reconstruct Garage SF
........................... ............. :
TOTAL HOUSE SIF
Demo ...........
TOTAL GARAGE SIF
Check Appropriate Box for-ADurcant I
# Units (if Residential)
Use F ��oA*
................ .
Valuation $
...............................................
Cu Yd Cut
Cu Yd Fill
# Stories
4. Arch itect/Desig ner's Name Last First Lic. No.
.............. .................. - .................................... .......... ........ ....................................................
Arch itect/D esig ner's Address Architect/Designer's E-mail Address
............. - ............................................... ............................. - .................................................... ..............................
F7. 6. Contractor's Name Last First Lic. No. Class
-7
.................................. . .. ... . ..............
Contractor's Address Contractors E-mail Address
.............. . ........... ..... . ........
. ............ .......... .........
.. ...... ........ . . . ... .........
Telephone
.............
State
city F7 .............. ................ .. ... ......... .. .......... ......
OFFICEUSEONLY ENERGYP/CFEE$
GRADING P/C FEE $
PERMIT NO.
PLAN CHECK NO.
I Rev 1118107 ELEC/MECH/PLUM P/C PLAN CHECK FEE $
L I NEWPORT BEHCH
CITY OF
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W1.1
HARBOR PERMIT
TRANSFER APPLICATION
829 Harbor Wand Drive
W
Newport Beach, CA 92660
949-644-3044
**Date of Applicatowd'a 11, Permit Number,
**Property Address: a06_ C>F,>ANC-
&�n!PORT Rvprl4 - ir-8 qa6-YGQ
f 11
"Buyer's Names:
Billing Address: I �Lc) 50,vv�-ex�
qq(0 tj
Telephone No., Zf -1
Buyer's Signatures:
"Seller's Names:
Seller's Signatures:
Joint Owner Signature- IVA
e-i4i .40-r-ucr "Escrow Company: ja�E?,y C�Q it-sobu. Phone#(?#�) -,�Lrj,7, -01.;V/
"Address_2 -.%Vy2
"Escrow Number: M
V - *#* 0 -/,54 **Fax .9 �qgy 3�t
Closing Datb (Estimate):
*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE
Inspection Date, jpbAl 1) Reinspection Date.
Fee Paid: 6�--A�) Chpp"6 01,
Application Complete;
Harbor
sPecial Conditions: Thi.5 permit h-, revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
June 21, 2011
West Coast Escrow
Fax# 949.707.0247
Re: Pier Permit #801-205
205 Grand Canal
Escrow # MV -02750
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,
461fra A/tI&Alf
Lisa Walters
Harbor Resources Division
INSPECTION FORM
Harbor Resources Department
Date:
Inspection Requested By:
Inspector:
Pier Address:
Z
Pier Transfer
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Eelgrass
Reinspection
YeX Need None Needed Yes Need
Date Time r] Eelgrass Within 15' of Project
r] Eelgrass Within 15'- 30'of Project
F1 No Eelgrass in Project Area
Pump Out
Pier Location
Yes No
Operational I I I
Recommended Action
Encroachmenet
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Comments / Observations
Other Request
Map Output Page I of I
http://www6.city.newport-beach.ca.uslservleticom.esri.esrimap.Esrimap?ServiceName=n... 06/15/2011
L'ITY OF NEWPORT BERCH
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A.- DATE
WORKSHEET FOR BUILDING / FIRE PERMIT APPLICATION
CITY OF NEWPORT BEACH HARBOR RESOURCES Di
PLEASE PRINT OR TYPE (9 BUILDING DEPARTMENT CITY OF NEWPORT BEACH
1 . PROJECT ADDRESS (NOT MAILING ADDRESS) /-N --- FLOOR ISUITE NO. ---
26 -5- 60 &"1 �4-� 1
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK -e --4t661
_7 f9
NEW At d DD F-1 ALTER F� DEMO F�
Check Amronriatp- Rny fnr Annlit-!mnf
No. UNITS
USE
# OF STORIES
VALUATION $
SQ FT
(NEW/ADDED/EXTG)
3. OWNER'S NAME LAST—
RST
OWNER'S ADDRESS
- -CM4 C444�
OWNER'S E-MAIL ADDRESS
CITY STA��
A/ � \-� I
ZIP
PHONE NO
�2,3 (
4. ARCH ITECT/DESI GN ER'S NAME —LAST
FIRST
LIC. NO.
ARCH ITECT/DESI GN ER'S ADDRESS
��Tr=CT/DESIGNERS E-MAIL Ab5—REss-
CITY STATE--
ZIP
PHONE NO.
5. ENGINEER'S NAME LAST
FIRST
STATE LiC. NO.
R'S AD
ENGINEE SS
ENGINEER'S E-MAIL ADDRESS
CIT STATE
ZIP
PHONE NO.
6. CONTRACTOR'S NAME
BUS)NE$S LIC. STATE LIC.
-?tlass
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j NN .-2'? "
CONTP CTOR 'SS
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`7
CONTRACTOR'S E-MAIL ADDRESS
C 'ITY STATF,
zlpc?2,� PHONlg-NQ�
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. Ge
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $
PLAN CHECK ENG.
rorms\blag.application 8/27/04