HomeMy WebLinkAbout20190801_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
~ Coastal Development Permit D Limited Term Permit -
D Waiver for De Minim is Development D Seasonal D < 90 day 0>90 days
D Coastal Residential Development D Modification Permit
D Condominium Conversion D Off-Site Parking Agreement
D Comprehensive Sign Program D Planned Community Development Plan
□ Development Agreement □ Planned Development Permit
'°'~\1,,9 ~ f7A2ol4J\<l
~ CITY OF NEWPORT BEACH
,__---100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
D Use Permit -□Minor □conditional
D Amendment to existing Use Permit
D Variance
D Development Plan D Site Development Review -D Major D Minor
□ Amendment -□Code □PC □GP □LCP
D Other:
D Lot Line Adjustment D Parcel Map
2 .. Project Address(es)/Assessor's Parcel No(s) 1-1 G 41-. Cr~&sfvt 6w,, ,
3. Project Description and Justification (Attach additional sheets if necessary):
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4. Applicant/Company Name I E,(U'"c..., f v rJ\os'<;>l\/\6"1\) t ~ ~ I
'ZoZS w 4 o~v'3o9-, ~vv~ '1:,.1 ~nit"--1,...:-_-_·~-=--=--=--::::.:::::'.il
City ~. State I~ I Zip '-\. --Z,(.. (,, J;
Phone------------Fax I I Email r\c&v\~St>M0.J'J (Q (::, ~,uJ
5. Contact/Companyf._..:..:..N::,:am:..::.e::::..:::::I ====s=~=~==\6===~==.j==~==(O(= .... =~=~==========:.-----;:=:========i"'
I ~ 1' . ..J..-<' ci/L~u • r ,~ 1 x:?e·> I I Mailing Address .~ <--. '-~~ .. c" ' _, <h. ~ Suite/Unit";:::=========~
City I ~l~--f 46,~ I State l.--~---1 Zil) I ~%&5-I
Phone I . =i Fax ~I ---~-~' Email============================
6. Owner Name I "Ro i'3 Wch.11<it..NS J T te..V~ f~Q, ~ w ,(jli-f~ f y:2..,-.t'!I-\:, I
Mailing Address I ·2 Co ±1.,, c~ V t-1,t,uJ 17 f2-./ Suite/Unit I I
City I (\/~-t,\:-f.2,cJV I Statel .----e_-,~---1 Zip\ ~(.kb 3 I
Phone I I Fax ~I ____ __.I Email~----------~
7. Property Owner's Affidavit*: (I) (We) I Rob ,R;f.... vite'J{_
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (We) further
certify, under penalty of perjury, that the foregoing statements and answers herein contained and the information
herewith submitted are in all respects true and correct to the best of (my) (our) knowledge and belief.
Signature(s): ~ cJ(IJf:7,);ir° Title: I f@6'll1:f 6 P -~~te: • .j.fii LJi?JJ '<J ::r@lsrm=· D ;Z 6f,uEfJ~
Signature(s): ___ •. ----------Title: f72 ut17ie I Date: , -' ~' ... J
*May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurrently with the
application. Please note, the owner{s}' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized.
F:\Users\CDD\Shared\Admin\Planning_Division\Applications\Applicalion_Guidelines\Planning Permit Application -CDP added.docx Rev: 01/24117
PA2019-151
F:\Users\PLN\Shared\Staff_Dir\Garciamay\Ruby\desktop\DESKTOP_\CUT_PASTE_DRAG_COPY\Office Use Only.docx
Updated 08/15/17
FOR OFFICE USE ONLY\
Date Filed: _______________________ 2700-5000 Acct.
APN No: __________________________ Deposit Acct. No. ________________________
Council District No.: _________________ For Deposit Account:
General Plan Designation: ____________ Fee Pd: _______________________________________
Zoning District: _____________________ Receipt No: ____________________________
Coastal Zone: Yes No Check #: __________
Visa MC Amex # ____________
CDM Residents Association and Chamber
Community Association(s): _______________________ Development No: __________________________
_____________________________________________ Project No: ________________________________
_____________________________________________ Activity No: _______________________________
Related Permits: ___________________________
APPLICATION Approved Denied Tabled: _________________________
ACTION DATE
Planning Commission Meeting
Zoning Administrator Hearing
Community Development Director
Remarks:
__________________________________________________________________________________________
__________________________________________________________________________________________
APPLICATION WITHDRAWN: Withdrawal Received (Date): ________________________
APPLICATION CLOSED WITHOUT ACTION: Closeout Date: ________________________
Remarks:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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PA2019-151