HomeMy WebLinkAbout20210304_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
0 Approval-in-Concept -AIC # 0 Lot Merger
0 Coastal Development Permit O Limited Term Permit-
□ Waiver for De Minimis Development O Seasonal O < 90 day 0 >90 days
0 Coastal Residential Development D Modification Permit
D Condominium Conversion D Off-Site Parking Agreement
D Comprehensive Sign Program D Planned Community Development Plan
0 Development Agreement D Planned Development Permit
0 Development Plan O Site Development Review -D Major D Minor
0 Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
I C)Lf"\-\~s-\2
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100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
0 Traffic Study
D Use Permit -□Minor □Conditional
D Amendment to existing Use Permit
[!] Emergency Temp. Use PermiVCDP
D Variance
0 Amendment -□Code □PC □GP O LCP
~ Other:
3. Project Description and Justification (Attach additional sheets if necessary):
Temporary Outdoor dining area during COVID 19 closures
4 A I. t/C N I 22nd Street Pizza I
. pp ,can ompa:,::n'..!y....:..:.:a:.:m~e-===============================::;--------;::==========:::;·
11803 Hummingbird Drive I I
Mailing Address Suite/Unit ';:::=========.
City ,_I C--;:o=s=ta=M=e=s=a========.-~=======-....:S~t.ate j CA I Zip 192626 I
1949-500-0763 I I I . I Laura@22ndstreetpizza.com I Phone Fax . Email __ ------------~-
I Laura Marroquin I
5. Contact/Company~N:.:a:.:.:m:.:.:e~=================================.-------;:==========i'
I Same as above I I Mailing Address Suite/Unit--;:::::==========:
City '--;:=================:;---;=======::::::=...~State ._I --;::::============-1......:z::.:.i!::...p =I===========;!
Phone ..... I ______ ___.I Fax .... I ____ ___.I Email -----------~
I Surfer Building LLC I
6. Property Owner N~a~m~e==================================.---------;===========·
Mailing Address I 1803 Hummingbird Drive Suite/Unit I
I Costa Mesa I CA I 192626 I City ~====================,---;::::::::::======~~St.ate Zip .
1
949-500-0763 I j I Laura@22ndstreetpizza.com I Phone Fax ,___ _____ _. Email
I Laura Marroquin I
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 submitt gll'.:S~11::cts true and correct to the best of (my) (our) knowledge and belief.
Title: I Manager I Date: I 03/04/2021 ~f,/----411:;__--=-----------DD/MO/YEAR
Signature(s): ______________ Title: .,_I _________ ........ I Date: ..... I _____ __,
*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.
PA2021-045
Agreement to Provide and Maintain Liability Insurance for Temporary Use of Public Property
Agreement to Indemnify defend and hold harmless the City of Newport Beach
Emergency Temporary Use Permit No. ____________________ _
Business/Permittee: ~'2., f\."'-~ ~.'Z ... 1-0.....
Address/Location: ~ ~ • ~~~ \ \M\\-\-~
Unless otherwise indicated, I will obtain and maintain commercial general liability insurance on an
"occurrence" basis, including completed products and completed operations, property damage, bodily
injury and personal and advertising injury with a limit of not less than $1,000,000 per occurrence. This
insurance shall be endorsed to name the "City of Newport Beach, the City Council, its employees, and
agents" as additional insureds, and provide that this insurance is primary and non-contributory with any
other insurance or self-insurance available to the City. Permittees shall also maintain workers'
compensation as required by the State of California with Statutory Limits, and Employer's Liability
Insurance with a limit of not less than $1,000,000 per accident for bodily injury or disease. The Workers'
Compensation policy shall be endorsed with a waiver of subrogation in favor of the "City of Newport
Beach, the City Council, its employees, and agents." If permittee maintains broader coverage and/or
higher limits than the minimums provided in this Section, the City requires and shall be entitled to the
broader coverage and/or higher limits maintained by the permittee. All policies shall be issued by an agent
or representative of an insurance company licensed to do business in the State of California, which has
one of the three highest or best ratings from the Alfred M. Best company. All insurance policies shall
contain an endorsement obligating the insurance company to furnish the Community Development
Director with at least thirty (30) days written notice in advance of the cancellation of the policy. I
understand the City reserves the right to require a permittee to submit the requisite insura nce documents
for review at any time.
Permittees shall agree to defend, indemnify and hold harmless the City and its employees from and
against any and all claims, demands, obligations, damages, actions, causes of action, suits, losses,
judgments, fines, penalties, liabilities, costs and expenses (including without limitation, attorney's fees,
disbursements and court costs) of every kind and nature whatsoever which may arise from or in any
manner relate (directly or indirectly) to the issuance of the emergency temporary use permit. This
indemnification shall include, but not be limited to, damages awarded against the City, if any, costs of suit,
attorneys' fees, and other expenses incurred in connection with such claim, action, or proceeding whether
incurred by applicant, City, and/or the parties initiating or bringing such proceeding ..
An approved and executed permit constitutes a contract between the City and Permittee for all purposes.
On behalf of the business/permittee:
nd Title \,-,
Date
PA2021-045