HomeMy WebLinkAboutPA2022-002_20220104_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC #
IX] Coastal Development Permit
D Lot Merger
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
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 -□Minor □Conditional
D Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP OLCP
D Other:
2. Project Address(es)/Assessor's Parcel No(s) I :~48-28?-37 -/4-[3-'Z--~~-l Q~~rJ--~ ----· __
3. _ _!)roject_!?e~~iJ?tion and Justif~~ation J~!!a~h additional sheets if necessaryt_ ___ _ ---, Demolish an existing slo.9!.e family residence and construct a new single family residence with a pool / spa and
lands_caping __ -=jC; 3_tps ~/ :1"~: _<f ~ ~-="JMAj 4___ __ _ _ _ ____
1 4. Applicant/Company Name rc;iton Graham I GRAHAM Architecture
Mailing Address l 12?8 G~~re Street J Suite/Unit I 107 _ j
City I Laguna Beach
Phone I 949-715-2355-
State ~I _C_A ____ I Zip ,.--92-65_1 ___ 1
·1 Fax ,_J=N=/ A==------__J-I Email I carlton@grahamarchitecture.com I
I Same as Line 4 above I 5. Contact/Compan!-y~N~a~m~e-===================,-----;=======i'
Mailing Add,.'....re~s~s:'.....:::=====-=-=--=----==-=-==-==---=-----;::::::=-====' Suite/Unit ,..._ ____ J
City ,-State I -I Zip I I
Phone L _ _ j Fax I I Email [-_-_-~--_ ___ ·i
I H;~e Mclain 6. Property Owner Name _ r-----------J r --
Mailing Address ~Strands _ _ Suite/Unit __ _
City [ L~~don, Engla~d --~ State ~=----] Zip l W21~N
Phone 1. N~A_ _ __ =i Fax 1 .-N_/_A ______ j Email L N/ A
I -i
--]
. . j Helle Mclain ] 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 and correct to the best of (my) (our) knowledge and belief.
Signature(s): -=-..e::....::--=::....::::::::__:...=::~~~::~---Title: f Owner I Date: /12121121
MM/DD/YEAR
Signature(s): _______________ Title: I ----1 Date: l-~-
j
J
• 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.
I.\Users\CDO\Shnred\Admin\Plonn1ng_01vision'v\pplications\Application_ Guidellnes\Planning Permit ApplicatI011_2021.docx Rev O li24117
PA2022-002
I:\Users\CDD\Shared\Admin\Planning_Division\Current_Templates\Office Use Only Form Updated 01/27/2020
2700-5000 Acct.
Deposit Acct. No. ________________________
For Deposit Account:
Fee Pd: _______________________________________
Receipt No: ____________________________
FOR OFFICE USE ONLY
Date Filed: _______________________
APN No: __________________________
Council District No.: _________________
General Plan Designation: ____________
Zoning District: _____________________
Coastal Zone: Yes No Check #: __________
Visa MC Amex # ____________
CDM Residents Association and Chamber
Community Association(s): _______________________ Development No: __________________________
_____________________________________________ Project No: ________________________________
_____________________________________________ Activity No: _______________________________
Related Permits: ___________________________
Remarks:
________________________________________________________________________________________
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PA2022-002