HomeMy WebLinkAboutPA2022-075_20220401_Application(
Community Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit ~ Limited Term Permit-
□ Waiver for De Minimis Development D Seasonal l)o < 90 day 0>90 days
O Coastal Residential Development O Modification Permit
0 Condominium Conversion O Off-Site Parking Agreement
D Comprehensive Sign Program O Planned Community Development Plan
D Development Agreement O Planned Development Permit
D Development Plan O Site Development R~view -D Major D Minor
0 Lot Line Adjustment O Parcel Map
PA,07-~-01-s
' '"' '" .,~,~ /'J-',
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
0 Variance
0 Amendment -□Code □PC □GP OLCP
0 Other:
2. Project Address(es)/Assessor's Parcel No(s) ----------::........!....------.......;...-------~·-,---
0 }00 \N.e½f ...... -~~1J3o~ _.J3J~. Ct _________ _
3. Pre>ject Description and Justification (Attach additional sheets.if necessary}:.
, i-----~-Hl-i~p.,_-f.e"f ~i te~· ~ ~wat-1'-'~ft)t...4-~ f'rJu~ civ~i~ .hoff~f,
:_:J:f.~-~nQ~~Le.-~'7 f,, :f&wY1 J~HL~:..l:Uf.~_y:qJ.~~~~-~-'--·-·······-·-.. -·-...
4. Applicant/Company Name I H:>:.\I l Lfto'-J.5 .. "1 r::of tt 13:it S,0t4'L ----~----·-·,
Mailing Address [_3}.Q_Q ______ , J~~---™-~£~_ .. _'Q_l~_Q__ I Suite/Unit[ _____ . I
City L.~e~r¢-:r .... 6.~H=., . ····-. ···• . .J State L. -~~A~ ···-.. _. . .J Zip t_q ~lele s·· -·-· ,-···---.-.-----·---------1 ·,· .-:•-··•-. ..-·· ... -1 r· ..... _--·--··"'--··-·--.'"--·--...
Phone l_Qj'j -:'#}!5-z_:,q_'? __ J Fax Jq~:.lf1i::.?T?:il Email ~~S}!f'J.Q~t4.vt.ty.11.CQ(YJ
5. Contact/Companl Name L __ fl~. f40flt:..be1J /...flJ.&d-::,:J,:J '{;. ~ l:tC,-:_ .
Mailing Address I _9.JQ'Q ___ .}~ ___ }J~Z::L(2_dcc ..... bt(Q .. , ____ ....... J Suite/Unit L __ _
City l __ N.e_~J_.PJ..4(?-'! .. ,:&ac8-.. -...... , ..... ·---·--·-···· .. -·.,-,, , State [=CA-=, ............ , ,,; Zip r···--~--.~·-·-l:-i•U_k·3 ..
Phone !_q'N:-hJS'::i~~] Fax LC/Ylf :¾:?f:~if Email [lfJ.~cq_K@;;;{fa.~~ •lCWI
6. ~~er Namer·-.,.'·,:::~ .. --~~~-·c~!kr _2;~ .... · . r~ io~
Ma1hngAddress ·--~l.J.a. ,,, .. &le.~~--:( .. fL_ ... ···"---R-L .. , j Su1te/Umt ........ -... .
City L -tt~~?.bffi---~---· ~j _ State L _Ct-L .. -~ .J z1pf1.~kfC ..
7· ;;~~~~;~~~~~~;;~;.;x~~~of~~~;,'.i~i~:;)',=) Jj
certify, under en lty f pt3rjury, that the foregoing statements and answers herein contained and the information
herewith r in all respects true and correct to the best of (my) (our) knowledge and belief.
. ... ---;olP'-~t"""tt"r---------Title: j ~,rt"-~~'( ...... ] Date: ~~:ki-:;_j
I r·---------..
+---"'----------------Title: .... ·------------· .. Date: t ___ , ...
···-, •.... ~---/ '"'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:IUserslCOD\Shared\Admir,\Pranning_OJv!slOfl\Applicalions\Application_Guidalines\Planning Permit Application• CDP added.cloc:x Rev: 01/24/17
PA2022-075
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:
________________________________________________________________________________________
PA2022-075