HomeMy WebLinkAboutPA2023-0024_20230128_NB ADU QuestionnairePOR
OF
CITY OF NEWPORT BEACH
ACCESSORY DWELLING UNIT (ADU) ANDD
oer JUNIOR ACCESSORY DWELLING UNIT (JADU) CALIF QUESTIONNAIRE
NA, WORS CH DAVID LSON
1 Property Owner Name
2 Property Address 1TUsTi AVE
What is the size and bedroom 8SO Square feet
count of your ADUIJADU:
_bedrooms
For multiple units, please attach a table) What is the current monthly rent,
or if not occupied, the anticipated
monthly rent?
(For mutiple units, please attach a table)
$ OOO_month
Utilities included? Yes No
O Rental/ Supplemental Income
Permanent housing for senior
relatives
What was your primary reason for
developing the ADU/JADU?
Permanent housing for non-senior
relatives
OPermanent housing for caretakers
O Permanent housing for household
employee
D Guest housing for visitors
O Other
6 Which unit do you intend to live
in?
Main house
Accessory Dwelling Unit
O Junior Accessory Dwelling Unit
ONone
Zaach) Signature
KA WOKSCAL Print Name Date
Please scan and emall completed questionnalre to me at: (lnsert Email)
Do Not Complete Questionnaire Below This Line-For Oficial Use Only PA No. Zoning Clearance No. ZC Approval Date
Buiding Pemit No. Building Pemit lssued Date Income Category
Planner Remarks Date