HomeMy WebLinkAboutM2008-0061Worksheet for Building Combo Permit Application
City of Newport Beach - Building Dep
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Please print 3 copies WBON RESOURCES DI
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1. Project Address (Not mailing address)
# Units (if Residential)
Tenant Name(if Applicable)
2. Description of Work
4/1
Exist House SF Demo House SF Add/Reconstruct House SF
Exist Gar SF Demo Garage SF Add/Reconstruct Garage SF
F
ew TOTAL HOUSE SF
N 0
Add f— Alter r—Dem
TOTAL GARAGE SF
Check Appropriate Box for Applicant
Use L, k -
Valuation $
Cu Yd Cut
Cu Yd Fill r
# Stories I
Lic. No, F
4. Architect/Designer's Name Last
First I
Architect/Designer's Address Arch itect/De!.���,ail Address
city
5tate
Zip Telephone
;t .. .... .......... .. . .. ....... .. .. .....
OFFICEUSEONLY ENERGYP/CFEE$
GRADING P/C FEE $
PERMIT NO.
PLAN CHECK NO.
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Rev 7178107 ELEC/MECH/PLUM P/C PLAN CHECK FEE $
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CITY OF NEWF -RT BEACH FIRE MARINE, DEPARTIVIENT
HARBOR PEl%,,,____'APPLICAT1.ON (Please print all infr,.- 1�:)n)
10 A
T_Ap� tGcant jgrop6rty Own?� Address J1 Telephone
9, -7 Z � i . I I-,.. / 'En I / �0 5e_�,(o
Project Address (Street Address#
3. New Construction �,_Revlsion
r Permit Number
Maintenance Dredging
4. Fee Check No. Date
5. Brief Description of Proposed Work: 42p-. d, 't— .0�
J J-\6( (u) 0�/
6. Submit 8 1/2" x 11" Drawings (3), Include: 1�i
1). Location and dimension of proposed structure including piles and location of existing -structures.
on adjacent� properties.
2). Lo6afion 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 M11.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).S6ale 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 co I rev side,of this sheet)
8. Applicant'slAgent's Signature: Date: �2
p able): 6ate:
Joint Permittee Signature (if ap lie.
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 finaill until we have conducted a.n on �site inspection. -once, construction is
completed as per Municipal Code, Section 17.24,.if we hiive not been contacted for,a-final inspection.
OFFICE USE ONLY
Approyal'in Coricept. Date
Approval of the -City ofNewport Beach Council. Date
Approval of the Army Corps of Engineers Date
Approval of the California Coastal Commission. Date
Approval of the City's Public Works Department. Date
Approval of the City's Building Department. Date
Approval of County of Orange. Date
Electrical andfor plumbing permit (Building Department) Date
L_-, ssudd. (Permit is stamped drawing)
I Date
Site Inspection. (call 644-3043 for appointment) Date
Site, R:e-Inspection Date
Conditions:
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).
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 tl-ds reason:
Owner s Si,
Contractor:
Address: a;
License cla-.:
nate-
License Contractor's Declaration
I hereby affirm that I am licenso under . sions of Chapter 9 (commencing with Section
7000) of Division 3 of the B4i�me/s a Profe sions Code, and my license is in full force and
effect.
Date:
Contractor's Signature =
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IF .04 PER7 IT
HARBOR
GRASTED TO CONSTRUCT AND
iFRMISSION Is tirm:ky ':.RSF HERE OF.
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-;AINTAIN THE FACSUTY -T�'T,-;z ',;"Rclv4slows� ol
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,iT -THV- SITE INDICAYEO, j- OEACli
pF-RMIT POLI&'r-5 Or to ivi"'i p 0 2'
rI4Z HARBOR N THIS
CONDITIONS USTED VIERF0 - l"L" kqq o
,kNy SpF-CIAL Affffl—MN
SFERABLE Wj-rV.OUT THF I q 74, �4,;
,S t4o-f TRAN r"ROH CoorDtNATOR OR,CITY COU'N�*- 4,
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TITLE JL7 OF I
IN ACCORDANCF WIT" T,
cl HAR R COO
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PERMIT NO -
SPECIAL CONDITIONS:
Corps Of Engineers Permit 1—
Oralige County Permit
Other
PERMIT ISSUED SUBJECT TO DREDGE MATERIAL BEING PLACED ON ADJACENT BEACH
PERMIT NO.
DREDGING APPLICATION
Project Location:- RPA W. RA -7 Air^ Xoftwnn-Tr� Rp.,q(-h
Cubic Yards to be Dredged:
Method
of
Dredging T-Tir,'-I-n nii
1 -1 n +-. i n n
Nature
of
Dredged Material:
Sand/silt
Disposition of Dredged Material: Discharge to beach reclamation, site
method of Material Disposition: Pipeline transport to reclamation area
Turbidity Control Method: Reduced discharge velocity/turbidity curtain
Effect of dredging on contiguous bulkheading and beaches Reinforce/
--Protect bulkhead -Restore sand to dep eted beaches
Mark S. Sites hereby state that I have read the U, S. Army
(print name)
Corps of Engineers permit for maintenance dredging in Newport Harbor, the
City of Newport Beach and orange County Harbors,Beaches and Parks District
(if applicable) permit for maintenance dredging and that I accept all the
I
provisions therein. Additionally I guarantee that the proposed dredging
will not occur because of any altering of existing use of the affected
zone.
Guilford Babcock Intracoastal Dredging
(Appl-icari-E-type name) (Contractor- type name) ---'---
6/2/8'; S i g n e d
__42 Ie. -1
(Date) Contractor s
Representative
CITY OF NEWPORT BE,#,
p� Commons
HARSOR, P"Rm�,y
PERMISSID, corns
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CiTY HARSOR coGRDjjqTky—oj-q
By CITY CQUIVOL
PER 1T J --
DATE
PERMIT NO.
DREDGING APPLICATION
Project Location:— 826 W. Bay Avenue
Cubic,Yards to be Dredged: 92
Method of Dredging: Hydraulic Suction
Nature of Dredged Material: Sand/Silt
Disposition of Dredged Material: Place material on adjacent beach
Method of Material D isposition: PuM through discharge pipe to disposal
fill area
Turbidity Control Method: Filter screen around discharge site
Effect of dredging on contiguous bulkheading and beaches Will restore
depleted beach and reinforce bulkhead
Wm, L. Harris hereby state that I have read the U. S. Army
(print name)
Corps of Engineers permit for maintenance dredging in Newport Harbor, the
City of Newport Beach and Orange County Harbors,Beaches and Parks District
(if applicable) permit for maintenance dredging and that I accept all the
provisions therein. Additionally I guarantee that the proposed dredging
will not occur because of any altering of existing use of the affected
zone.
Guilford Babcock
(Applicant -type name�—
Shellmaker, Inc.
(Contractor -type name)
Signed:
Representative
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County peralit
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CITY OF NEWPORT BEACH
HARBOR PERMIT
PERMISSION IS HEREBY CRANTED TO CONSTRUCT AND
MAINTAIN THE FACILITY SHOWN ON THE REVERSE HEREOFV
AT THE SITE INDICATED, SUBJECT TO THIS PROVISIONS Of
THE HARBOR PERMIT POLICIES OF NEWPORT BEACH Allf,
ANY SPECIAL CGND;TlCNS L.ISTED HEREON. THIS PERM-"
IS NOT TRANSFERABLE WiTHOUT THE WRITTEN CONSENT G. -
THE CITY HARBOR COORDINATOR OR CITY COUNCIL. TH,
RIGHTS GIVEN UNDER THIS PERMIT ARE PERMISSIVE ON0
AND THIS PERMIT MAY BE, REVOKED SY THE CITY COUNCIL
IN ACCORDANCE WITH TITLE 17 OF THE MUNICIPAL cpsl�-
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TJ . �, J;pv
CITY HAIRSOR CODRDMATOR
F "RIT NO. DATE
SPECIAL CONDITIONS:
Corps of Engineer s P emit 10,7-70
Orange County Permit
Other.
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CITY OF NEWPO'RT REACH
HARBOR PERMIT
PERMISSION IS VEREBY GRANTED TO CONSTRUCT ANID'
MAINTAIN THE FACILITY SHOWN ON THE nz�j�zRS2:
AT THE
I:fERF
SIT' _OF
THE JECT TO THE P:"0vtSj0lqS
SPECIAL CONDITIONS:
Ol
POLICIES OF NZ%&,po
ANY SPEC?AL RT REACH A,*Jr
Permit
'Coios 'Of gineers
I'S NOT TRANC USTFD TtUS
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Permit
ountv Permit
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Permit
'AND TH ARE prr,
IS PERIWIT pE. '"��;SSIVE ONL
REVOKED
BY T.42 CTY CoUNCII
'N ACCORDANCE WITH TITL E I THE CODE.
CITY HA OR CoGRDT�4—A—TOR
PERMIT ISSUED SUTl—CC`r--T'(T DREDGE MATERIAL.
BEING PLACED ON, ADJACENT BEACH
SPECIAL CONDITIONS:
Cer-ps Of Engineers Permit
Orange County Pirmit
Other
i