HomeMy WebLinkAbout20181017_ApplicationCommunity Development Department
Planning Permit Application
CllY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
1. Check Permits Requested:
D Approval-in-Concept -AIC #
D Coastal Development Permit
D Lot Merger
D Limited Term Permit -
D Staff Approval
D Tract Map
D Waiver for De Minim is Development D Seasonal D < 90 day 0>90 days D Traffic Study
D Coastal Residential Development D Modification Permit D Use Permit -OMinor 0Conditional
D Condominium Conversion D Off-Site Parking Agreement D Amendment to existing Use Permit
D Variance • Comprehensive Sign Program D Planned Community Development Plan
D Development Agreement D Planned Development Permit D Amendment -DCode DPC OGP DLCP
D Other: 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)
I 3!>o OIJ
3. Project Description and Justification (Attach additional sheets if necessary):
I
4. Applicant/Company Name I M; ~(, UeJ{Q(°>\.4.1,,. I 8u If! sd ~ ~-rc.s I
Mailing Address I 2'181 I=, W~+e. ~~ Ave... I Suite/Unit ';::========I
City I AttA~i I State I CA I Zip I 'lzao, I
Phone I 7 1 t.f -ZS S -'t IO'"\ I Fax I 711.i-, '5o -6oll j Email lf\'.\i ke@S1..u,1.ck,b, 'cr'S oc.. C...OH--z ,
5. Contact/Company~N~a~m~e~l~S~""~"'=S=e.=i===~~i=l~I==~~=========,-------;::======;'
Mailing Address I 218\ £. 'WW\.-e ~Ar /J.v(,. Suite/Unit '-;:::=====',
City I A~ ~el \\6 I State L_cii~=========--' ~Z=.!ip~I =q=z=e=o =' =:
Phone 1714 -Z-5 S .. '-ti O "f Fax l7 J&4 • "~ O -C,o l \I Emai I !...!Cl f\;\'--'-'i~~;,uc.~~~'..n.l,)._J,A,,,.._.__cp,
6. Owner Name '--------'---=;tJ=~===l=b=( .\.==='=4=w=l,o,=======~=<-O==; (,,.="""=\===y=\~Col.==~=;-=~c.1-~~====::':S~
Mailing Address 3 3 O CIJ tJ~v-l pu+ Bl_vJ. Suite/Unit ';:::=====
City I rJ~ p.r~ ~L I State I a4 I Zip I '12.,, ~ I
Phone h1&.1 · 8 5 O -7 5 1 5 I Fax ~---~I Email I S kOJ> II\;._@ ft ti.a,; ) . CblllAc
7. Property Owner's Affidavit*: (I) (We) ~I ______________________ ___,
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/MO/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.
F:\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_Guidelines\Planning Permit Application -CDP added.docx Rev: 01/24/17
(" ..-------------FOR OFFICE USE ONLY\
Date Filed: ____ l___;:0:;._•__..1 ___ '1"--• __ J_g ___ _ ~00-5000 Acct.
APN No: 'i). S :33/ /6 Deposit Acct. No.----------
Council District No.: __ cl.......,._ ___ _ Fa
General Plan Designation: f1a -6::
Zoning District: D b-
Coastal Zone: D Yes ,12&.No
D COM Residents Association and Chamber
Community Association(s): "' \J (\, ~'N,,......,.,-H&4---+-------
Related Permits:------------
Development No: l)~ l S-O;;l g L.l
Project No: ff\)-<W) & --;i.. 3 ']
Activity No: Q. $ /A:)) g -OOb
APPLICATION D Approved D Denied D Tabled:
Remarks:
0Planning Commission Meeting
DZoning Administrator Hearing
0Community Development Director
ACTION DATE
~. '(f'\.
APPLICATION WITHDRAWN: Withdrawal Received (Date): ----------
APPLICATION CLOSED WITHOUT ACTION: Closeout Date: ----------
Remarks:
F:\Users\CDD\Shared\Admin\Planning_Division\Applications\Office Use Only.docx
Updated 08/15/17