HomeMy WebLinkAboutM2003-0090CITY OF NEWPORT BEACH. �-HAR80R,:.,Aj?PLJCATlOW
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WORKSHEET FOR BUILDING / FIRE PERMIT APPLICATION
CITY OF NEWPORT BEACH HARBOR RESOURCES DIV.
CITY OF NEWPORT BEACH
BUILDING DEPARTMENT
PLEASE PRINT OR TYPE (9
1. PROJECT ADDRESS (NOT MAILING ADDRESS FLOOR SUITE NO.
=7tp/d
LEGAL DESCRIPTION No. UNITS
LOT BLOCK TRACT
2. DESCRIPTION OF WO8K DOC, USE 01POR Bjn�-t—
# OF STORIES
VALUA . TION $ 90,
mw Ig ADD ALTER DEMO SQ FT
(NEW/ADDED/EXTG)
. Check Appropriate Box
r-1 3.
OWNER'S NAME
4LAST
�Aoolr
144A I/
FIRST
OWNER'S ADDfIESS
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L -:Ps
OWNER'S I -MAIL ADDRESS
I
CITY
AF
STATE
<��,�
71 P
7?'14 10
PHONE NO.
6 3�
4.
ARCHITECT/DESIGNER'S NAME LAST
FIRST
LIC. NO.
A
ARCHITECT/DESIGNER'S ADDRESS
ARCHITECT/DESIGNER'S E-MAIL ADDRESS
CITY
STATE
ZIP
PHONE NO.
5.
ENGINEER'S NAME
LAST
FIRST
STATE LIC. NO.
ENGINEER'S ADDRESS
ENGINEER'S E-MAIL ADDRESS
CITY
STATE
ZIP
PHONE NO.
6.
CONTRA S NAI�
C�Mll yi,
B-USINE,)S LIC.
B40 ' .
STATE LIC.
No.7970S�ass
CON RACT R' AIDD)PS F
0
CONTRACTOR'S E-MAIL ADDRESS
Cr
STA,,�;EA
Q-17—
ZIF�
IPHONE NO.
OFFICE USE ONLY
TYPE OF CONSTRUCTION
L-OCCUPANCY - GROUP
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $
PLAN CHECK ENG.
Fonn"Idg—applicaflon 10-18-02
PUCATION: WO.
CJTY OF," NEWPORT'St-ACH. -14ARW A.0P 77/0
CITY OF NEWPORT BEACH
HARBOR PERMIT
PERMISSION IS HEREBY GRANTED TO CONSTRUCT AND
MAINTAIN THE FACILITY SHOWN ON THE FZEVERSE HEREOF,
AT THE SITE INDICATED, SUBJECT TO THE PROV;SIONS Olp
THE HARBOR PERMIT POLIC;ES OF NEWPORT BEACH A%r-
.ANY SPECIAL CONDITIONS LISTED HEIREON. THIS PERMI'.
IS NOT TRANSFERABLE WiTHOUT THE WRITTEN CONSENT Qi -
THE CITY HARBOR COORDINATOR OR CITY CCUNCIL. THP
RIGHTS GIVEN UNDER THIS PERMIT ARE PERMISSIVE ONLY
AND THIS PERMIT MAY BE REVOKED 13Y THE CITY COUNCIL
IN ACCORDANCE WITH TITLE 17 OF THE MUN 7
JCD g:
CITY HARBU"OORDINA—MR—
Pff"I -2--//-7,/
1 . 1. 1 —,, DATE
SPECIAL CONDITIONS:
Corps of Engineers Permit A0 - 7e2
Orange County Permit
O'ber'
CITY OF NEWPOF BEACH HARBOR APPLluj4lj.-ION NO./-Tr�/V
At 'r
C%
VICIMITY SKETCH
eETc 14 .,,6 14ow &e.4C
7-t---NKwPoRr 5AY, CAL loroRNIA
F
ft Oct. —.#,c
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CITY OF NEWPORT BEACH
HARBOR PERMIT
PERMISSION IS HEREEY ISPAINTE0 TO CONSTPUCT AND
MAINTAIN THE FACILITY 51031�qN
NDACATED,
AT THE SITE V 7 Z r Z'j Z R S 2. A � F-9 E o F,
Ear
POUl' 'Fs CIF rj!7
THE HARBOR P TO PROV.Slons
AN Y S P Z-: c 1.6 DEACN tIN,
IS
THE Cjy-y
RIGHTS --:q yl,,;,�,�-.
AND THIS PERrvicy M, irl,�V M" 2,�,f c c 0 U N, cd
IN ACCCRDANCE WJyj 17 E �U%jCi AL CODE'
IT ORIN TOR
/-33 - JO FEB 2 5 1970
PERMIT
---_PATF.
SPECIAL CONDITIONS:
Corps of Engineers Permit
Orange County Permit
Other: r "
-., ,,, -,e - :2 — /� - 70