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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: ________________________________________________________________________________________ □ □ □ □ □ □ □ □ PA2021-268