HomeMy WebLinkAbout20170616_Application~(>(J{)(f -\ ~al
Community Dev·elopment Department
Planning Permit Application
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
1. Check Permits Requested:
0 Approval-in-Concept -AIC # 0 Limited Term Permit -
0 Coastal Residential Development D Seasonal D < 90 day 0>90 days
0 Condominium Conversion O Modification Permit
0 Comprehensive Sign Program O Off-Site Parking Agreement
0 Staff Approval
0Tract Map
0 Traffic Study
0 Use Permit -O Minor 0Conditional
0 Development Agreement O Planned Community Development Plan
0 Development Plan O Planned Development Permit
0 Amendment to existing Use Permit
0 Variance
0 Lot Line Adjustment O Site Development Review -D Major D Minor
0 Lot Merger Ii] Parcel Map
0 Amendment -OCode OPC OGP OLCP
0 Other:
2. Project Address(es)/Assessor's Parcel No(s)
1242-244 Catalina Drive, Newport Beach, CA 92683 / 425-382-10
3. Project Description and Justification (Attach additional sheets if necessary):
Create a parcel map for condominium purposes.
4. Company\ Applicant IForkert Engineering & Surveying, Inc.
Mailing Address !22311 Brookhurst St. Suite/Unit l2o3 I ';::========
City !Huntington Beach
Phone 1714 963-6793
State ,_lc_A--;::::::::==============-1 ~Z::.'..!ip~'==92==6==4==6========~1
I Fax ~-----~I Email '-----------------'
5. Company\Contact !Thomas E. Decker I
Mailing Address 122311 Brookhurst St. Suite/Unit ';::12=0=3=======1,
I
City !Huntington Beach State !cA I Zip 192646 I
Phone 1714.963-6793 Ext. 2441 Fax'------~l ·Email ltomd@forkertengineering.com I.
6. Owner Name ishibla LLC / Greg Wayer I
Mailing Address 1242-244 Catalina Drive Suite/Unit ';:===========I
City I Newport Beach State ,_I C_A-;:::====='.._I ~Z~ip~'=92=6=8=3===.I
Phone !(949) 293-1500 I Fax ,_ _____ I Email ,__ __________ ____J
7. Property Owner's Affidavit*: (I) (We) ,_!s_h_ib_l_a_L_L_C_/ _G_re_g_W_a_:.y_e_r ____________ _
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, ;re in all respects true and correct to the best of (my) (our) knowledge and belief. /s-6-/ 7,
Signature(s): ~2 / ;(Jf / Title: I ;1/&;,,,o. 1 i-//!tf-/1,M,,f_ Date: I U I
, DD/MO/YEAR
Signature(s): ---------------Title: ,__ _________ _J 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 -NEW.docx Rev: 02105/15
PA2017-129
FOR OFFICE USE ONLY
Planning Activity History:-----------------------------
Date Filed: _ _.....~L....»<'---''--1-----2700-5000 Acct.
APN No: _Y..£.><J'-'--"s=----_.>_g_z._._) u __ _
Council District No.: ·~ __ .;__ ___ _
General Plan Designation: RT
Zoning Di strict: _ _,(l,___-1-_____ _ Receipt No:------~~----
Coastal Zone: D Yes 1t(No Check #: ___ _
Visa D MC D Amex D # ____ _
D COM Residents Association and Chambe, :Jb
Community Association(s):NWfXS* ~~
~-~-
Development No: O'Lt l-1 -aOS9
Project No: ---"--P...,..,...t\~~-l_t _--_l _c._~ ___ _
Activity No: ---'N'--f.,_t-0~_(7_ ... _0_I_~ ____ _
APPLICATION D Approved D Denied D Tabled:
Remarks:
0Planning Commission Meeting
0Zoning Administrator Hearing
0Community Development Director
ACTION DATE
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 06/06/17
PA2017-129
II All-purpose Acknowledgment California only
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 ____ _J,tf,,0_~~=:,:,2'cc_ ___________________________ _
before me, ::/bo"""'-,S ke [I» .S~;-11-, Alo·~ T'~b Ii t.-(here insert name and title of the officer),
personally appeared -----=['~"-~-;sdr'D~r-;+----L_. --~w=/A.,=)J,,.=e~v ______________ _
who proved to me on the basis of satisfactory evidence to be the
person¢ whose name~is/9re subscribed to the within instrument
and acknowledged to me that he/j.l,e-/tt,ey executed the same in his/
lj;,rftn;,if authorized capacity(~, and that by his/llel/their signature/sJ'
on the instrument the person(,f, or the entity upon behalf of which the
perso').(5) 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.
Description of Attached Document
Notary Seal
Type or Title of Document C,.,..vv,0~ D,,.,4~ D~,J; · -£f~ ()~ ~
Document Date _____ __,Oe.c/,,.,__-~1~;/,.<.--~;)"'o_,_1~1:---~ Number of Pages _____ ( ________ _
Signer(s) Other Than Named Above
Scanner !nabled Stores should scan this fonn
Manual Submission Route to Depo!/t Operations
0SGSJ50CA (Rev01-01/1S) F001-000DSG5350CA-01
PA2017-129