HomeMy WebLinkAboutPA2022-0290_20221130_PlanningPermitApplication _house Community Development Department
Planning Permit Application
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
F:\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_Guidelines\Planning Permit Application - CDP added.docx Rev: 01/24/17
1. Check Permits Requested:
Approval-in-Concept - AIC # Lot Merger Staff Approval
Coastal Development Permit Limited Term Permit - Tract Map
Waiver for De Minimis Development Seasonal < 90 day >90 days Traffic Study
Coastal Residential Development Modification Permit Use Permit -Minor Conditional
Condominium Conversion Off-Site Parking Agreement Amendment to existing Use Permit
Comprehensive Sign Program Planned Community Development Plan Variance
Development Agreement Planned Development Permit Amendment -Code PC GP LCP
Development Plan Site Development Review - Major Minor Other:
Lot Line Adjustment Parcel Map
2. Project Address(es)/Assessor’s Parcel No(s)
3. Project Description and Justification (Attach additional sheets if necessary):
4. Applicant/Company Name
Mailing Address Suite/Unit
City State Zip
Phone Fax Email
5. Contact/Company Name
Mailing Address Suite/Unit
City State Zip
Phone Fax Email
6. Owner Name
Mailing Address Suite/Unit
City State Zip
Phone Fax Email
7. Property Owner’s Affidavit*: (I) (We)
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): ________________________________ Title: Date:
DD/M0/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.