HomeMy WebLinkAbout20191023_Application_Community Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval -in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit-
□ Waiver for De Minimis 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
D Development Plan D Site Development Review -D Major D Minor
D Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
'VA7,o \Q-i l 7
CITY OF NEW PORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644 -3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
") V'Q : lO 1~~ / A
D Use Permit -□Minor □Conditional
D Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP OLCP
D Other:
:1-$ f I e, I µ;tE !#.!VE A 'If : -1tJ6
3. Project Description and Justificatio (Attach additional sheets if necessary): .
I
pt;M,t,/11~/J ,F TE) ~~ AND ~IN5ffOIPf lfl/J t,p NEAi
3 STP/(Y SF/!-
4 . Applicant/Company Name E f2.l C pt,SE'i
Mailing Address 1-7 'Z-8' ~~ coAJr I/WY. nit I A J
City c ~ 'fJ-t>1J~ ~/,, MAI< State CA Zip I 'f ~ 2-5 I
Phone l14q. if1• gtt;G I Fax =--1 ----, Email I eri&(Jt-riCtJlse11Je;i.fj11. ~,,/HJ
5. Contact/Company~N~a~m~e:....:::===S=Pr/Y1E==============;-----;::::.===-=-=-=-=-=-=-::;'J
Mailing Address Suite/Unit ';=====~I
City -'------;========,-----;=::=====:_-S:::.:tate ~-;::::=======:_' ~~:z:-·-.;:=====:'
Phone ~--------~ Fax ~-----~J Email ~I ________ "-----~
6. Owner Name I TP)11J\ Y NJ[J M.A~/lrlJNE. LA~J/t)
Mailing Address I 1--?f / CI~ Cl E-{2/(./VE Suite/Unit ";:::=======:::::::
City I Nc-/l'lp f!..T BEACJf J State I ~A J Zip 0 -2k~~-~~
Phone It ~l~--~uozq] Fax ___ ~I Email 'J± 'p.J'f-in ~ ~ _ mtt,1· .C,()fVJ
7. Property Owner's Affidavit*: (I) (We) L!i~~~~~~7J~")fi~t1M,4~~5:.....n_~w◄~'()~/lll,l).~~~:.::..:.'Ni~'!~/.A::.!.~~l~~:___J
depose and say that (I am) (we are) the ow er(s) of he property (ies) involved in this application . (I) (We) further
certify, under penalty of pe~ury, that the foregoing statements and answers herein contained and the infom1ation
herewith submitted are in all respects true and correct to the best of (my) (our) knowledge and belief.
Signature(s): Title: I C> WNE/t.. J Date: I/~ /t-t /'l t/1 I --j!},ff-'!-__.l!::::~.t=~------1 DDJM6/YEAR
Signature(s): ~~~~.m~===-----Title: ~I _~_W_N_£_P-___ ~J Date :~() /,i.1 / 1011
*May be signed by the lessee or by an authorized agent if written authorization from the owner of reco rd 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:\Users\C DD\Shared\Admin\Planning_Divi sio n\Applica tions\Appli ca ti on_Guidelines\Pl anning Pe rmit Appli cation -CDP added.docx Rev: 01 124117
PA2019-217
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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:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
BAYSHORES COMMUNITY ASSN.PA2019-217
10.23.19
3
R-1
RS-D
049 174 06
CD2019-053
D2019-0519
PA2019-217