HomeMy WebLinkAboutPA2021-268_20211108_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
D Development Agreement D Planned Development Permit
D Development Plan D Site Development Review -D Major D Minor
D Lot Line Adjustment D Parcel Map
2. Project Address(es}/Assessor's Parcel No(s} I 139 North Bay Front, Balboa Island
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
0 Amendment -□Code □PC □GP □LCP
D Other:
3. Project Description and Justification (Attach additional sheets if necessary}:
Demo Existng Single-Family-Dwelling and Garage. Construct New 3 Story Single-Family-Dwelling with Attached Garage.
4. Applicant/Company Name I Ian Harrison, Architect
Mailing Address !220 Newport Center Drive #11-342 Suite/Unit ';=:========::::',
City !Newport Beach I State !CA I Zip 192660
Phone 1949-723-1091 I Fax I I Email l1an@lanHarrisonArchitect.com
5. Contact/Company Name I Ian Harrison
Ma iii n g Address Suite/Un it ~::.::.-=--=--=-=====:::
City ~;::========-=-=-=-=-=-=-=-=-.=,------;::=========--~St.ate ~------1 Zip I
Phone l Fax.,_! _____ ____.I Email~-------------~
6. Property Owner Name !Gary and Dottie Gunderson
Mailing Address I 139 North Bay Front
City !Balboa Island
Phone l626-354-9229
Suite/Un it ';:I ===========:
State lcA I Zip 192662
Fax ~I ----~I Email lgarygun52@yahoo.com
7. Property Owner's Affidavit*: (I) (We)~' G_a_ry_G_u_n_d_e_r_s_o_n ______________ ~
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): "::....... h~ ~ Title: I owner I [)ate:~' ----~ ~ ) ~ ' MM/DD/YEAR
Signature(s ): ' Title: ===================== Date: '-------~
*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.
I :\Users\CDD\Shared\Admin\Planning_ Division\Applications\Application _ Guidelines\Planning Permit Application _2021.docx Rev: O 1124/17
PA2021-268
I:\Users\CDD\Shared\Admin\Planning_Division\Current_Templates\Office Use Only Form Updated 01/27/2020
2700-5000 Acct.
Deposit Acct. No. ________________________
For Deposit Account:
Fee Pd: _______________________________________
Receipt No: ____________________________
FOR OFFICE USE ONLY
Date Filed: _______________________
APN No: __________________________
Council District No.: _________________
General Plan Designation: ____________
Zoning District: _____________________
Coastal Zone: Yes No Check #: __________
Visa MC Amex # ____________
CDM Residents Association and Chamber
Community Association(s): _______________________ Development No: __________________________
_____________________________________________ Project No: ________________________________
_____________________________________________ Activity No: _______________________________
Related Permits: ___________________________
Remarks:
________________________________________________________________________________________
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PA2021-268