HomeMy WebLinkAbout20170130_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
%Coastal Development Permit D Limited Term Permit-
D 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)
I /)... 11~ 1';;4"1 ~~ pp.,ve..
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
D Use Permit -OMinor O Conditional
D Amendment to existing Use Permit
D Variance
D Amendment -O Code O PC O GP OLCP
D Other:
3. Project Description and Justification (Attach additional sheets if necessary):
I oe-e.. /¥/r~
4. Applicant/Company Name I /;4-JJ ti;Aff--l~t:PtJ 7ijiC1f I Jl!:oT I
Mailing Address I ?J~?;G ~ C#}~ 16:1/v-1/o/ I Suite/Unit l=#'"~t9/ I
City I U?fklfl~ I~ WI-I State I qr-I Zip I cr~~z,~ I
Phone I t?fJftff-1-z~-/oe:ll l Fax I Emaii i/.ANV~~IT
5.
City ~;:::::===============!----;::========:..........:~ ~----------------~~ Fax ~----------~
Suite/Unit ';=========~
I Zip
6. Owner Name I 't..(~ tJ.A-"(:5/kf1e, 1..-(....C;
Mailing Address I ( 0~ frV/Ht/!:., ~If/ Jt be.( Suite/Unit 'r====~
City I H~~tz:'l ~ I State l---1 Cf'--;:· ==========-I ~Z~ip_.=l q.=rz_==~===~
Phone I q tf1 .... 1t~t!?-&~ l rJ I Fax I Email ,____ _________ __,
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 submitted are in all respects true and correct to the best of (my) (our) knowledge and belief.
Title: I &?W&=;t? I Date: I /fotP C]
DD/MOIYEAR
*May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurre ntly with the
application. Please note, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized.
F:\Users\COO\Shared\Admin\Pianning_Divislon\Applications\Application_ Guidelines \Planning Permit Application -COP added.docx Rev: 01124117
PA2017-019
( )
FOR OFFICE USE ONLY
Date Filed: 0 ~?tJ/t 7
Fee Pd: ;;2, ~0
7
Check#: Visa 0 MC~# 3 "B / ~
Receipt No: iJ::'4JcJtJ7otJ cj'
APN No: 01-9 / ~ ;2_}p
Council District No.: 3
General Plan Designation: _f?.:l -t-D"---
Zoning District: £,. -I
Coastal Zone: aLKyes 0 No 0 2700-5000 Acct. 0 Deposit Acct. No. ________ _
Community Association(s): {3atfshatZ.J
i'ttmtlUI'mo/ .~:z hd-zc 2
Development No: /~ {;2/)17 -tJ ~/
Project No: IJt-c?0/7.--t11 9
Acti vity No: Cj).;;;oJ ? .-(2() 5
APPLICATION 0 Approved 0 Denied 0 Tabled:
Remarks:
0Pianning Commission Meeting
0Zoning Administrator Hearing
0Community Development Director
ACTION DA TE
APPLICATION WITHDRAWN: W ithdrawal Received (Date): ----------
APPLICATION CLOSED WITHOUT ACTION: Closeout Date: ----------
Remarks:
F:\Users\CDD\Shared\Admin\Pianning_Division\Applications\Office Use Only.docx
Updated 05/14/15
PA2017-019
IAN J.N. HARRJSON ~ AR_CHITECT
January 30, 2017
COASTAL DEVELOPMENT PERMIT APPLICATION
APPLICANT: Kevin Moriarty
2782 Bay Shores Drive
Newport Beach, CA 92663
LOCATION: 2772 Bay Shore Drive, Newport Beach
PROPOSED DEVELOPMENT: Demolition of a two-story single-family residence and garage,
and construction of a two-story, 29-foot high single-family residence of approximately 2,523
square feet, with an attached 469 square foot two-car garage. The proposed project also
includes 280 cubic yards of grading over-excavation for compaction and drainage. All storm
water and run off from non-permeable surfaces will be collected and directed toward
landscaped and permeable areas or an underground drainage system. All landscaping will be
non-invasive and consist of primarily drought tolerant plants species. No work is proposed on
the dock.
APPROVAL RATIONALE: The project site is located on a developed 4,000 square foot lot in
the Bay Shore Community fronting the Newport Harbor in an established neighborhood of
Newport Beach, Orange County. The subject site is located between the first public road,
Coast Highway, and Newport Bay because the subject site is located in the locked gate
community of Bay Shore. No public access currently exists through the site. However, the
project will have no impacts on existing coastal access. Public access to the harbor exists
upcoast adjacent to the Bay Shore Community at the Balboa Bay Club. The Applicant received
an Approval-in-Concept from the City of Newport Beach on September 26, 2016. A letter has
been submitted by William Simpson and Associates which states that the bulkhead will last for
the life of the development once the proposed replacement of tiebacks and dead men is
performed. The site is designated as R-1, residential land use by the City of Newport Beach
and the proposed development is consistent with the zoning. The proposed project will comply
with all setback and height requirements. Law water need and non-invasive landscape palette
will be used to minimize the need for irrigation. The proposed development will not adversely
impact coastal resources, public recreation opportunities, and is consistent with past
Commission actions in the area.
3535 EAST COAST 1-liGI-IW AY, #301 -CORONA DEL MAR., CALIFORNIA 92625 -949 I 723-1091
PA2017-019
PROJECT: Moriarty Residence
2772 Bay Shore Drive
Newport Beach, California
In response to the increased need to address water quality and drainage issues, the following mitigation
measures will be incorporated during and after construction.
During the grading of the site the grading contractor is directed to leave a depression at the rear of the site
a minimum of six inches below the natural grade to collect any water run off during construction. In
addition, sand bags are require at the property lines, to assure water is diverted to this depressed area so
no water drains into the street or boardwalk.
The drainage system is designed to retain concentrated and surface sheet flow water from dry-weather
run-off and minor rain events within the site. Run-off water will sheet flow toward planters. Surface area
drains and downspouts are directed to an underground drainage system, which drains toward the rear of
the lot. The last 15 feet of this drainline is perforated and encased in gravel so that water collected will be
absorbed into the sandy sub-grade before it can go out to the street or alley. The drainage at the rear of
the lot is directed over a french drain prior to draining toward the street. The STATE REGIONAL WATER
QUALITY CONTROL BOARD's Water Quality Best Management Practices are incorporated into the
Plans
Low water need and non-invasive landscape palette will be used to minimize the need for irrigation.
PLANTING PALETTE
BOTANICAL NAME
Agave Desmettiana 'Variegata'
Rosmarinus 'Irene'
Lavandula 'Goodwin Creek Grey'
Bougainvillea 'La Jolla'
Alyogyne Huegelii
Callistemon Citrinus
(Train to small tree)
Carpenteria Californica
(Train to small tree)
COMMON NAME
Smooth Agave
Rosemary
Lavender
Bougainvillea
Blue Hibiscus
Dwarf Bottebrush
Bush Anemone
3535 EAST COAST I-IIGHW AY, #301 -CORONA DEL MAR, CALIFORNIA 92625 -949 I 723-1091
PA2017-019
APPENDIX B
LOCAL AGENCY REVIEW FORM
SECTION A (To BE coMPLETED BY APPLICANT)
Applicant /?tf;,v;/Y !1rf?/ /tf?r;/
Project Description Ci!Ht?~/S~~~.et.h'....V~~~~
~{??/J~I __ ;:k:Jt-. ~ ~~
Assessor's Parcel Nu'lllber 'Oft-/ q/ -z.e
SECTION 8 (To BE COMPLETED BY LOCAL PLANNING OR BUILDING INSPECTION DEPARTMENT)
Zoning Designation JZ-\ ~~~-----------------------------dulac -------
General or Community Plan Designation ---'~'----'-"'~"--_,S),__ ______________ _ dulac -------
Local Discretionary Approvals
rRl Proposed development meets all zoning requirements and needs no local permits other than building
permits.
D Proposed development needs local discretionary approvals noted below.
Needed Received
CEQA Status
D D
D D
D D
D D
D 0
D 0
D D D D
D 0
D 0
Design/Architectural review
Variance for
Rezone from
Tentative Subdivision/Parcel Map No.
Grading/Land Development Permit No.
Planned Residential/Commercial Development Approval
Site Plan Review
Condominium Conversion Permit
Conditional, Special, or Major Use Permit No. ______________ _
Other
0 Categorically Exempt Class Item
0 Negative Declaration Granted (Date)
0 Environmental Impact Report Required, Final Report Certified (Date)
~ Other "::>\Q\v~cx~\-4, 8-®~ '3e.c.\lc.N\\~<ih3 l)A..\V\\.:,\et\C\\ 21u)~Lb)
Prepared for the ~County of ~~ Qo< \-~V\ by L\ 1.-w~~\e.\uV'I ~
Date '1-'Z..C,-\(, Title "f,">i7\a"' ~ \'\£<n~e<"
11
PA2017-019
APPLICATION FOR COASTAL DEVELOPMENT PERMIT
SECTION I. APPLICANT
1. Name, mailing address, and telephone number of all applicants.
Kevin Moriart
2782 Bay Shore Drive
Newport Beach, California 92663 949-300-031 0
(Area code/daytime phone number)
Note: All applicants for the development must complete Appendix A, the declaration of campaign
contributions.
2. Name, mailing address and telephone number of applicant's representatives, if any. Please include all
representatives who will communicate on behalf of the applicant or the applicant's business partners, for
compensation, with the Commission or the staff. (It is the applicant's responsibility to update this list, as
appropriate, including after the application is accepted for filing. Failure to provide this information prior to
communication with the Commission or staff may result in denial of the permit or criminal penalties.)
lan J.N. Harrison, Architect
3535 East Coast Highway, #301
Corona Del Mar, California 92625 949-723-1 091
(Area code/daytime phone number)
SECTION II. PROPOSED DEVELOPMENT
Please answer all questions. Where questions do not apply to your project (for instance, project height for a
land division), indicate Not Applicable or N.A.
1. Project Location. Include street address, city, and/or county. If there is no street address, include
other description such as nearest cross streets.
2772 Bay Shore Drive
number
Newport Beach
city
street
Orange
county
Assessor's Parcel Number(s) {obtainable from tax bill or County Assessor):
049-191-28
FOR OFFICE USE ONLY
APPLICATION NUMBER
RECEIVED
FILED
FEE
DATE PAID
I
PA2017-019
2. Describe the proposed development in detail. Include secondary improvements such as grading, septic
tanks, water wells, roads, driveways, outbuildings, fences, etc. (Attach additional sheets as necessary.)
Demolish existing two-story, wooden framed dwelling and garage.
Construct new two-story, wooden framed, single-family dwelling and garage.
Abandon Existing Pool and Spa.
Minor grading for compaction and drainage.
There will be no work performed on the existing dock.
a If multi-family residential state· '
Number of units Number of bedrooms per unit
(both existing and proposed)
Existing units Proposed new units Net number of units on
completion of project
NA
b. If land division or lot line adjustment, indicate:
Type of ownership
proposed
Oren tal
Ocondominium
Ostock cooperative
Otime share
Oother
Number of lots Size of lots to be created (indicate net or gross acreage)
Existing Lots Proposed new lots Net number of lots on Existing Proposed
comoletion of oroiect
NA
3. Estimated cost of development (not including cost of land) _c::$6::::5::::0c:,O.::.OO"'."'OO:__ ________ _
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4. Project height: Maximum height of structure (ft.) 29'-0"
• above existing (natural) grade .............................. .. 29'-0"
• above finished grade .......................................... .. 29'-0"
• as measured from centerline of frontage road .... .. 29'-0"
5. Total number of floors in structure, including
subterranean floors, lofts, and mezzanines ..................... 2
6. Gross floor area excluding parking (sq.ft.) ..................... _,2:c:,5:.=2.:...3.::.SF:.__ ________ _
Gross floor area including covered parking and
accessory buildings (sq.ft.) ............................................ _:2'"',9'""9"'"2-"-SF'-----------
7. Lot area (within property lines) (sq.ft. or acre) ..................... _4__,_,0'--0'-'3---'S'-'-F-----------
Lot coverage Existing (sq.ft. or acre) New proposed (sq.ff. or acre) Total (sq.ff. or acre)
Building 1,980 SF 2.207 SF 2,207 SF
Paved area 1,943 SF 1.588 SF 1,588 SF
Landscaped area 80 SF 208 SF 208 SF
Unimproved area -0--0--0-
Grand Total (should equal lot area as shown in #7 above) 4,003 SF
8. Is any grading proposed? ............................................................................ [g) Yes D No
If yes, complete the following.
a) Amount of cut 300 cu. yds. d) Maximum height of
cut slope NA ft.
b) Amount of fill 300 cu. yds. e) Maximum height of
fill slope NA ft.
c) Amount of import or -0-cu. yds. D Location of borrow NA export (circle which) or disposal site
Grading, drainage, and erosion control plans must be included with this application, if applicable. In certain areas, an engineering
geology report must also be included. See page 7, items# 7 and 11.
Please list any geologic or other technical reports of which you are aware that apply to this property:
9. Parking:
Number of parking spaces (indicate whether standard or compact)
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PA2017-019
Existing Spaces Proposed new spaces Net number of spaces on completion of project
2 2 2
Is any existing parking being removed? ....................................................... . DYes 1Zl No
If yes, how many spaces? size ------------------------
Is tandem parking existing and/or proposed? .............................................. . DYes 1Zl No
If yes, how many tandem sets? __________ size ________ __
10 Are utility extensions for the following needed to serve the project? (Please check yes or no)
a) water b) gas c) sewer d) electric e) telephone
D D 0 D D
Yes Yes Yes Yes Yes
IZI No IZI No IZI No IZI No IZI No
Will electric or telephone extensions be above-ground? .............................. D Yes D No
11 ' Does project include removal of trees or other vegetation? ......................... IZI Yes D No
If yes, indicate number, type and size of trees
or type and area of other vegetation Low Shrubs and one 12" and one 1 0" tree
SECTION Ill. ADDITIONAL INFORMATION
The relationship of the development to the applicable items below must be explained fully. Attach additional
sheets if necessary.
1. Present use of property.
a. Are there existing structures on the property? ..................................... .. 1Z1 Yes D No
If yes, describe
Existing two-story, wooden framed dwelling and garage.
In Ground Pool and Spa
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PA2017-019
b. Will any existing structures be demolished? .......................................... ~ Yes D No
Will any existing structures be removed? """'""'""'"'"'""'""'"'"'"'"'' D Yes ~ No
If yes to either question, describe the type of development to be demolished or removed, including the relocation site, if
applicable.
Demolish existing two-story dwelling and garage.
Abandon existing pool and spa.
2. Is the proposed development to be governed by any Development
Agreement? .................................................................................................. .
3. Has any application for development on this site including any subdivision
been submitted previously to the California Coastal Zone Conservation
Commission or the Coastal Commission? ................................................... .
If yes, state previous application number(s) ________ _
4. a. Is the development between the first public road and the sea (including
lagoons, bays, and other bodies of water connected to the sea) .......... .
b. If yes, is public access to the shoreline and along the coast currently
available on the site or near the site? .................................................. ..
D Yes ~ No
D Yes ~ No
~ Yes D No
~ Yes D No
If yes, indicate the location and nature of the access, including the distance from the project site, if applicable.
Project is located in a gated community. Public access to beaches near by.
c. Will the project have an effect on public access to and along the
shoreline, either directly or indirectly (e.g., removing parking used for
access to the beach)? .......................................................................... ..
If yes, describe the effect
D Yes ~ No
5. Does the development involve diking, filling, draining, dredging or placing structures in open coastal
waters, wetlands, estuaries, or lakes? (Please check yes or no)
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PA2017-019
a) diking b) filling c) dredging d) placement of structures
D D D Yes D Yes
Yes Yes
[gj No [gj No [:8'1 No [gj No
Amount of material to be dredged or filled (indicate which) .:..:N:..:.A __________ c::.::u:.:_. L::Yd:..::s
Location of dredged material disposal site NA
Has a U.S. Army Corps of Engineers' permit been applied for? ................... D Yes D No
6. Will the development extend onto or adjoin any beach, tidelands,
submerged lands or public trust lands? ........................................................ D Yes [:8'1 No
For projects on State-owned lands, additional information may be required as set forth in Section IV,
paragraph 10.
7. Will the development protect existing lower-cost visitor and recreational
facilities? ..................................................................................................... . D Yes [:8'1 No
Will the development provide public or private recreational opportunities? .. D Yes [:8'1 No
If yes, explain.
NA
8. Will the proposed development convert land currently or previously used for
agriculture to another use? ........................................................................... D Yes [gj No
If yes, how many acres will be converted? ________ _
9. Is the proposed development in or near:
a. Sensitive habitat areas (Biological survey may be required) .......................... .
b. Areas of state or federally listed rare, threatened, or endangered
species ................................................................................................. .
c. 1 DO-year floodplain (Hydrologic mapping may be required) ............................ .
d. Park or recreation area ........................................................................ ..
10. Is the proposed development visible from:
a. State Highway 1 or other scenic route .................................................. .
b. Park, beach, or recreation area ............................................................ .
c. Harbor area .......................................................................................... .
D Yes [gj No
D Yes [gj No
D Yes [gj No
[gj Yes D No
D Yes
[gj Yes
[gj Yes
[gj No
D No
D No
11. Does the site contain any: (If yes to any of the follow'1ng, please explain on an attached sheet.)
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PA2017-019
a. Historic resources ................................................................................ . D Yes [g] No
b. Archaeological resources ..................................................................... . D Yes [g] No
c. Paleontological resources .................................................................... .. D Yes [g] No
12. Where a stream or spring is to be diverted, provide the following information:
Estimated streamflow or spring yield (gpm) --'N..::.A.:..._ _____________ _
If well is to be used, existing yield (gpm) -----------------
If water source is on adjacent property, attach Division of Water Rights approval and property owner's
approval.
SECTION IV. REQUIRED ATTACHMENTS
The following items must be submitted with this form as part of the application.
1. Proof of the applicant's legal interest in the property. A copy of any of the following will be
acceptable: current tax bill, recorded deed, lease, easement, or current policy of title insurance.
Preliminary title reports will not be accepted for this purpose. Documentation reflecting intent to
purchase such as a signed Offer to Purchase along with a receipt of deposit or signed final escrow
document is also acceptable, but in such a case, issuance of the permit may be contingent on
submission of evidence satisfactory to the Executive Director that the sale has been completed.
The identity of all persons or entities which have an ownership interest in the property superior to that
of the applicant must be provided.
2. Assessor's parcel map(s) showing the page number, the applicant's property, and all other
properties within 100 feet (excluding roads) of the property lines of the project site. (Available from
the County Assessor.)
3. Copies of required local approvals for the proposed project, including zoning variances, use
permits, etc., as noted on Local Agency Review Form, Appendix B. Appendix B must be completed
and signed by the local government in whose jurisdiction the project site is located.
4. Stamped envelopes addressed to each property owner and occupant of property situated
within 100 feet of the property lines of the project site (excluding roads), along with a list
containing the names, addresses and assessor's parcel numbers of same. The envelopes must
be plain (i.e., no return address), and regular business size (9 1/2" x 4 1/8"). Include first class
postage on each one. Metered postage is not acceptable. Use Appendix C, attached, for the listing
of names and addresses. (Alternate notice provisions may be employed at the discretion of the
District Director under extraordinary circumstances.)
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PA2017-019
5. Stamped, addressed envelopes (no metered postage, please) and a list of names and
addresses of all other parties known to the applicant to be interested in the proposed
development (such as persons expressing interest at a local government hearing, etc.).
6. A vicinity or location map (copy of Thomas Bros. or other road map or USGS quad map) with the
project site clearly marked.
7. Copy(s) of plans drawn to scale, including (as applicable):
• site plans
• floor plans
• building elevations
• grading, drainage, and erosion control plans
• landscape plans
• septic system plans
Trees to be removed must be marked on the site plan. In addition, a reduced site plan, 8 1/2" x 11" in
size, must be submitted. Reduced copies of complete project plans will be required for large projects.
NOTE: See Instruction page for number of sets of plans required.
8. Where septic systems are proposed, evidence of County approval or Regional Water Quality Control
Board approval. Where water wells are proposed, evidence of County review and approval.
9. A copy of any Draft or Final Negative Declaration, Environmental Impact Report (EIR) or
Environmental Impact Statement (EIS) prepared for the project. If available, comments of all
reviewing agencies and responses to comments must be included.
10. Verification of all other permits, permissions or approvals applied for or granted by public
agencies such as:
• Department of Fish and Game
• State Lands Commission
• Army Corps of Engineers
• U.S. Coast Guard
For projects such as seawalls located on or near state tidelands or public trust lands, the Coastal
Commission must have a written determination from the State Lands Commission whether the
project would encroach onto such lands and, if so, whether the State Lands Commission has
approved such encroachment. See memo to "Applicants for shorefront development" dated
December 13, 1993.
11. For development on a bluff face, bluff top, or in any area of high geologic risk, a comprehensive, site-
specific geology and soils report (including maps) prepared in accordance with the Coastal
Commission's Interpretive Guidelines. Copies of the guidelines are available from the District Office.
SECTION V. NOTICE TO APPLICANTS
Under certain circumstances, additional material may be required prior to issuance of a coastal
development permit. For example, where offers of access or open space dedication are required,
preliminary title reports, land surveys, legal descriptions, subordination agreements, and other outside
agreements will be required prior to issuance of the permit.
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PA2017-019
In addition, the Commission may adopt or amend regulations affecting the
issuance of coastal development permits. If you would like notice of such
proposals during the pendency of this application, if such proposals are
reasonably related to this application, indicate that desire ................................... .
SECTION VI. COMMUNICATION WITH COMMISSIONERS
D Yes D No
Decisions of the Coastal Commission must be made on the basis of information available to all commissioners and
the publ'lc. Therefore, permit applicants and interested parties and their representatives are advised not to discuss
with commissioners any matters relating to a permit outside the public hearing. Such contacts may jeopardize the
fairness of the hearing and result in invalidation of the Commission's decision by court. Any written material sent to a
commissioner should also be sent to the commission office for inclusion in the public record and distribution to other
Commissioners.
SECTION VII. CERTIFICATION
1. I hereby certify that I, or my authorized representative, have completed and posted or will post the
Notice of Pending Permit card in a conspicuous place on the property within three days of
submitting the application to the Commission office.
2. I hereby certify that I have read this completed application and that, to the best of my knowledge, the
information in this application and all attached appendices and exhibits is complete and correct. I
understand that the failure to provide any requested information or any misstatements submitted in
support of the application shall be grounds for either refusing to accept this application, for denying
the permit, for suspending or revoking a permit issued on the basis of such misrepresentations, or for
seeking of such further relief as may seem proper to the Commission.
3. I hereby authorize representatives of the California Coastal Commission to conduct site inspections
on my property. Unless arranged otherwise, these site inspections shall take place between the
hours of 8:00A.M. and 5:00 P.M.
Signature of Authorized Agent(s) or if no agent, signature of Applicant
NOTE: IF SIGNED ABOVE BY AGENT, APPLICANT MUST SIGN BELOW.
SECTION VIII. AUTHORIZATION OF AGENT
I hereby authorize .:.:l~an~J . .:.:N.:.:. Hc.:.:a:::.r:.::ris:.:o_:n ___________ to act as my representative
and to bind me in all matters concerning this application.
Signature of App/icant(s)
(Only the applicant(s) may sign here to authorize an agent)
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PA2017-019
APPLICATION FOR COASTAL DEVELOPMENT PERMIT
APPENDIX A
DECLARATION OF CAMPAIGN CONTRIBUTIONS
Government Code Section 84308 prohibits any Commissioner from voting on a project if he or she has
received campaign contributions in excess of $250 within the past year from project proponents or
opponents, their agents, employees or family, or any person with a financial interest in the project.
In the event of such contributions, a Commissioner must disqualify himself or herself from voting on the
project.
Each applicant must declare below whether any such contributions have been made to any of the listed
Commissioners or Alternates (see last page).
CHECK ONE
D
The applicants, their agents, employees, family and/or any person with a financial
interest in the project have not contributed over $250 to any Commissioner(s) or
Alternate(s) within the past year.
The applicants, their agents, employees, family, and/or any person with a financial
interest in the project have contributed over $250 to the Commissioner(s) or
Alternate(s) listed below within the past year.
Commissioner or Alternate
Commissioner or Alternate
Commissioner or Alternate
Signature of Applicant or Authorized Agent Date
Please type or print your name --'K-"e-'-v"'in-"M""o,;,;,ria"'rt"'"y _______________ _
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PA2017-019
APPENDIXD
(Permit Application)
DECLARATION OF POSTING
Prior to or at the time the application is submitted for filing, the applicant must post, at a conspicuous place, easily read by
the public and as close as possible to the site of the proposed development, notice that an application for the proposed
development has been submitted to the Commission. Such notice shall contain a general description of the nature of the
proposed development. The Commission furnishes the applicant with a standardized form to be used for such posting. If the
applicant fails to post the completed notice form and sign the Declaration of Posting, the Executive Director of the
Commission shall refuse to file the application. 14 Cal. Code Regs. Section 13054(d).
Please sign and date this Declaration of Posting form when the site is posted; it serves as proof of posting. It should be
returned to our office with the application.
Pursuant to the requirements of California Administrative Code Section 13054(b), I hereby certify
that on, 1(.1~01~8!~ I ft7 I or my authorized representative posted the Notice
of Pending Permit for application to obtain a coastal development permit for the development of
New Single-Family Residence and Attached Two-Car Garage
(descnpllon of development)
Located at 2772 Bay Shore Drive, Newport Beach California 92663
(address of development or assessors parcel number)
Thepublicnoticewaspostedat ~;%~ ~~.:5/f? ~ I
(a conspicuous place, easily seen by the public and as cl~ the s~o:d development)
~=71~
I ' (date)
NOTE: Your application cannot be processed until this Declaration of Posting is signed and returned to this office.
FOR OFFICE USE ONLY
PERMIT NUMBER ................... ---------
RECEIVED ............................ ---------
DECLARATION COMPLETE .... ..
PA2017-019
SEE SECTION 13055 OF THE COMMISSION'S REGULATIONS (CALIFORNIA CODE OF REGULATIONS, TITLE 14) FOR
FULL TEXT OF THE REQUIREMENTS.
TO BE COMPLETED BY STAFF
SUBMITTED FEE VERIFIED BY: DATE:
IS SUBMITTED AMOUNT CORRECT?
D Yes. Applicant has correctly D Applicant did not fill out form, D No. Why?
characterized the development, thus staff has marked the form
and payment is appropriate. to compute the fee, and applicant
has paid fee.
REFUND OR ADDITIONAL FEE REQUIRED? (STATE REASON)
D Refund amount ( )
D Additional fee amount ( )
----
REMINDER: RECORD FEE PAYMENT IN PERMIT LOG
FINAL FEE VERIFIED BY: (TO BE COMPLETED AFTER COMMISSION ACTION) DATE:
7
PA2017-019