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Community Development Department
Planning Permit Application
CHY or NEVVPOf{T 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 Lot Merger
D Coastal Development Permit D Limited Term Permit -
D Waiver for De Minim is 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 20316 Irvine Ave Unit B1
D Staff Approval
D Tract Map
D Traffic Study
Iii Use Permit -li!Minor □conditional
D Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP □LCP
D Other:
3. Project Description and Justification (Attach additional sheets if necessary): l dental office . ·~···
4. Applicant/Compa ..... n ...... y_N-· a_m_e __ ·_ls_. __ u_c __ ._h-a-=n_n ___ a ___ n_. __ s_. _t ____ r_e-e~·_t_P=a.:::::-rt_n __ e_r_s-:....-....... -:....-_-_~--=--:....--_= __ --__ -_---=--=----------'--'---~~~-~ ~--_ ~-~--....... _ -....... ----_ -_ --_._I
Mailing Address I 1300 Bristol Street North . I Suite/Unitl 100 I
City jNewport Beach State I Calif . I Zip I 92660 I
Phone I. (949) 640-8911 I Fax j Email I surflaw@aol.com l
5 C t tic N •J Law Offices of Phillip B Greer I
. on ac ompany,_. . ..:... ~a::.m:.:.e::.. . .:::::::::=========:::::=======:::===============~~-~~-:;:..=--=--::::....=..::::....=..=-=-=-==--==-i~-
Maili ng Address I 1300 Bristol Street North I Suite/Unit] 100 I
City INewportBeach j State I Calif J Zip j 92660 I
Phone j (949) 640-8911 I Fax j j Email I surflaw@aoLcom j
6_ Owner Name J Buchanan Street Partners j
Mailing Address I 1300 Bristol Street North I Suite/Unit I 100 I
City j Newport Beach! State I Calif I Zip j 92660 I
Phone I (949) 640-8911 I Fax j I Email I surflaw@aol.com I
7. Property Owner's Affidavit*: (I) r,Ne) I Buchanan Street Partners 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 ~spects true and correct to the best of (my) ( our) knowledge and belief.
Signature(s): /VVf,,,-V "1--("A-..-;-Tille: I Vice President j Date: j Feb 28, 2020
DD/MONEAR
Signature(s): ______________ Title: I I 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