HomeMy WebLinkAboutPA2022-097_20220511_ApplicationCommunity Development Department PA ;2. C~.,)-0 drioF NEWPORT BEACH
Planning Permit Application 1 00 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger D Staff Approval
D Coastal Development Permit D Limited Term Permit -D Tract Map
D Waiver for De Minimis Development D Seasonal D < 90 day 0>90 days D Traffic Study
D Coastal Residential Development D Modification Permit D Use Permit -□Minor □Conditional
D Condominium Conversion D Off-Site Parking Agreement D Amendment to existing Use Permit
D Comprehensive Sign Program D Planned Community Development Plan D Variance
D Development Agreement D Planned Development Permit D Amendment -□Code □PC □GP □LCP
D Development Plan D Site Development Review-D Major D Minor fl_ Other: -ix-,A N Ci'\ ; J A"/) 11 N l0 □ Lot Line Adjustment □ Parcel Map 7JV n1 J VW~
2. Project Address(es)/Assessor's Parcel No(s) ;40~ I ~&.M~ 2.,0'-\0 t ~f~\/Vt·ew A..Vir NEWP8RT EEf\c.\--t CJz..,"o
3. Project Descrip 10n and Justification (Attach additional sheets if necessary):
:A.·'7 u a...d.c:\ 1,T\ ()t"\C.., l. J.we.~l-lT\) ~I--\' Vf'.J $ l /Ur)<----%0.nt~ ~
4. Applicant/Compa~nLy~N~a~m~e-=I ======J==t=M======A=V==':>=7t?'R,.=====1,==6=W==N::;::~;;--R.,;-;:;::::;:;------;;:::::::========.-'I
Mailing Address I pc, Bd'j. 1\l O:#l.~c'lf<s'OAttejGcf4,' ~:fte/Unit I
City I Chr<..B 6 NDM.-6 I State I <Lo I Zip I S? \ '-z, 3 I
Phone I 17 o G.!8 7b<j2-. Fax I Email I JiN\Av"::>re-~~ ~6T'f\l\A-JL-;. ~-----~ C:o Pl
I _j ( M f+V":>'T~ I 5. Contact/Companyf._.:;.N:::a::.:m:.::e:...:::==========::::::::========::::::::::::::::=========,----"""";:::::::::::::::::::::::::::::::::::::::::::~
Mailing Address I S ~ u,b ~~ ? b 6 t,;< ( I~ Suite/Unit I I
City I . C cu--6 c))\ · o.., , State I Lo I Zip I ~-l l ')., 3 I
Phone l97D b 1'5' 7GC'f'Jk.... I Fax~'---~' Email I \Jl{1'\(;\,\JS°½'rse-M Mti,1 I ,,0~
6. Property Owner Name I~ ~~ ~ I M ~ \.> ~qz_ I
Mailing Address I PO ~ 6 K { l (,.. I Suite/Unit I I
City I c_"".,, b ~ ~ s-J... ~ State I C 6 I Zip I 'S' ) L '2 s> I
Phone I 1J O _.£_ \ _g-. 1 f 1~1 Fax _j ~~~--' Email I ~ l hi\~ 0 , l
I'
7. Property Owner's Affidavit*: (I) (We) ..... -~..-=-.. ......... ~~-.......... fJ __ ·=v='~1_e=v-~_ ··=··· -~~--~--~----"-
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (YVe) 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):~' Title:I 6wve loa1e:I 'fL1rZ_. ~L-1 ~ MM/DD/YEAR
Signature(s): ~ a~ Title: I ✓ ... I Date: I u,/'1.-~ l?-id
*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.
PA2022-097