Loading...
HomeMy WebLinkAbout20190410_ApplicationCommunity,,_Qevelopment Department PlanninQ ~ermit Application 1. Check Permits Requested: D Approval-in-Concept -AIC # D Lot Merger Iii Coastal Development Permit D Limited Term Permit- □ 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 cifftfll{t)~IJ l.?M · AJ 100 Civic Center Drive flv, ,, Newport Beach, California 92660 949 644-3200 newportbeachca.gov/communitydevelopment D Staff Approval D Tract Map D Traffic Study D Use Permit-OMinor □Conditional D Amendment to existing Use Permit D Variance D Development Plan D Site Development Review -D Major D Minor 0 Amendment -□Code □PC □GP □LCP D Other: D Lot Line Adjustment Iii Parcel Map 2. Project Address(es)/Assessor's Parcel No(s) 3. Project Description and Justification (Attach additional sheets if necessary): New single family residence to be 2734 s.f. Living and 464 Garage. 4. Applicant/Company Name Jsrand0 ~ .A.~?hitects Jj Mail h1g ~cidrE:ls~ -l 1 ~ 5 ~ 1 ~K~~l~r11~~s~·· ·~~v~e~· · ~~~~~~~~~~~~=======::---__ S_u_i ...... te/Unit .... 1 . .,...G-:::::..~ 1 ........ _~ ..... ~-~-~-~---~-~-~-1 City jcosta ~esa State j CA !zip ~lg~2e_.2_e~~~~' Phone 171~.754A040 Fax ],... ........... _ ......... _____ I ~mail l1nf?@brandonarchitects.com I 5. ContacVCompany Name jca1tlin Smi th j Mailing ~dcirE:lSS =b_5 _ 1 ~K~al_m_u~s~~v_e~·. ~~~~~~~~~~~~========-'"'--S_u_i_te/Unit ....... I_G:::.~ 1-:::::..:::.-::.-::.-:::::.::::::::::::.=~I City jcosta Mesa State lcA I Zlp'--lg_2e_2~e-----~' Phone 171~-!5~.40~0 Fax -1-----.............. , Email kaitlin~~r~~~~~ar~~it~~ts.cor11 I 6. Owner Name !south B~yfront \f\/~terpoint~, ~~~-I Mailing Address 1 61 O Newport Center dr. Suite/Unit '---1_ 8-9_0_._. ::.-:::..======:::I City !Newport Beach State ..... ,C_A _______ I Zip 1~2660 I Phone 19~9·644·89?? Fax J_ ........................................................... , Email I 7. Property Owner's Affidavit*: (I) r,Ne) ~~~-~~~~-~~~~~~~-~~~~-~ depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) r,Ne) 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. Signatu~s::::::.~======----Title: l~ .. I Date: 11/~JJolR .• ~ Signature(s): ______________ Title:=' ~~~~=~~~~I Date: =j ~~~~~~' *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. ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of _________ ~ ss. On ___________ 20 __ before me, _____________ , Notary Public, personally appeared _____________________ , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their aut~orized capacity(ies), and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of C~rnia / / ,,,-;----• co~ o>y;'J. e:-t } ss. ( 1 ~ebrPra.lJ .!).es .:J ~01 S' On r, 0/ , 20 before e, , Notary Public, personally appeared (54-.rr'IC/~ 3la.cc e • '. proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. (seal) F:\Users\PLN\Shared\Staff_Dir\Garciamay\Ruby\desktop\DESKTOP_\CUT_PASTE_DRAG_COPY\Office Use Only.docx Updated 08/15/17 FOR OFFICE USE ONLY\ Date Filed: _______________________ 2700-5000 Acct. APN No: __________________________ Deposit Acct. No. ________________________ Council District No.: _________________ For Deposit Account: General Plan Designation: ____________ Fee Pd: _______________________________________ Zoning District: _____________________ Receipt No: ____________________________ Coastal Zone: Yes No Check #: __________ Visa MC Amex # ____________ CDM Residents Association and Chamber Community Association(s): _______________________ Development No: __________________________ _____________________________________________ Project No: ________________________________ _____________________________________________ Activity No: _______________________________ Related Permits: ___________________________ APPLICATION Approved Denied Tabled: _________________________ ACTION DATE Planning Commission Meeting Zoning Administrator Hearing Community Development Director Remarks: __________________________________________________________________________________________ __________________________________________________________________________________________ APPLICATION WITHDRAWN: Withdrawal Received (Date): ________________________ APPLICATION CLOSED WITHOUT ACTION: Closeout Date: ________________________ Remarks: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________