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HomeMy WebLinkAboutPA2022-009_20220110_ApplicationCommunity Development Department Planning Permit Application crn Of NEWPORf 8E,!\Ci-1 100 Civic Center Drive Newport Beach, California 92660 949 644-3200 newportbeachca.gov/communitydevelopment fl,E.CE IVS-D 1. Check Permits Requested: DE=,COMMUN1rt;. □ Approval-in-Concept -AIC # □ Lot Merger -tf' Slaff,AliWoval D Coastal Development Permit D Limited Term Permit -JA 110 Tract Map ; D Waiver for De Mini mis Development D Seasonal D < 90 day 0>90 days · v[j -f1-af!jf ~tudy / D Coastal Residential Development D Modification Permit D Use Permit -□Minor □Conditional D Condominium Conversion D Off-Site Parking Agreement err\-D Amendment to existing Use Permit D Comprehensive Sign Program D Planned Community Development Plan-t,~ D Cifariance □ Development Agreement □ Planned Development Permit tz-...00,.0 Amt,~~ment -□Code □PC □GP OLCP D Development Plan D Site Development Review -D Major D Minor 1J 15'tfler: D Lot Line Adjustment D Parcel Map 2. Project Address(es)/Assessor's Parcel No(s) I 2.,' 6 I Cfl,ff-$1 lit i~.-v../J/L J½~P,.v::r 3. Project Description and Justification (Attach additional sheets if necessary): f2.~vi4.., ,..;. ~ ~ "f7 1,,,/ 1:, 5 HLLJ LK~ ~ C-eJ,V t;/'l),(..JC.;t7/) 11.,1 co -A-N /~ ~ 0 h!1 · S:r6~ .S. 5-~ A-'H.J ):t 0 ~ SF i-+o ~ 'i:- 4. Applicant/Company Name I 1:>~-L D Mailing Address I .s:>---OO "5 {}-IV t?tJ;IV Pi~· Suite/Unit~-=--=--=--=-=====- City I /V ~tAi 1 -o ,!l.')-'·f:s ·~. t!--ld State I ;.-4-t.-,F I Zip I '7266 0 Phone 1760 4 19 '99/J Z--I Fax,__ ____ __.I Email I D.e ciiG/ @. h/1-AA--, '.:c.1~ 5. Contact/Company Name I ''bA..v,1.'.J IQ')07""" Mailing Address I S' ~i... .4.s' A---S. c)u,i, Suite/Unit City State I Zip Phone Fax I I Email I 6. Property Owner Name I t.:::,.<l..u.,L) 12€>&--.J.-~v~--'1CE-~ )" Mailing Address I S /¼<-;"C-A.s" ,A-lhr--1;, Suite/Unit I I I City State Zip Phone I Fax I Email 7. Property Owner's Affidavit"": (I) (We) I 77~ -f-~M'----t+ttE-12.©cir 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): /(aiJuL,,vf ££ Title: I (2Utvt=i:-<._ loate: I 7'/i/2.-L I MM/DD/YEAR Signature(s): _£~---4~_;j_Rl_C-_____ Title: ~I_&~, _u..--,_t_(.t,.,(__-~---~I Date: I < 2-,!-I *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 Parcelrrract Map and Lot Line Adjustment Application must be notarized. l:\Usem\CDD\Shared\Admln\Planning_Division\Applications\Application_Guidelines\Planning Permit Appllcatlon_2021.docx Rev: 01/24/17 PA2022-009 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: ________________________________________________________________________________________ □ □ □ □ □ □ □ □ PA2022-009 CITY OF NEWPORT BEACH Date: tlJ /2,,L I Permit Tech : ___ _ COMMUNITY DEVELOPMENT DEPARTMENT PLAN SUBMITTAL FORM Print Name: p/4:0ed) 'icpt;'T' Signature: ~J ./4!,)df: Phone#: 26t> ,?/l9'--99'oL Email: p.e.eJo>rG I"(!!.. &1~;1.(L. .e,......, □ Pick-up Plans Plan Check/Revision #: Project Address Additional Information 2¼ 6/ ~Sj7V'ti,;. JC,-1S.e.vt1,~ °&:cN Qf. P(submitting Plans Plan Check or Revision Number Number of Plan Name each document i.e., permit application, plans, structural calcs, soil Sets or documents Payment Method Payment can be made by credit card via phone at (949) 718-1888. r PAYMENTS MUST BE MADE AFTER 48 HOURS OF SUBMITTAL DUE TO QUARANTINE OF PLANS Notes: ~.4~· f::co_t . Q)M 7'>4-l, A,>t'4 . j'-'/l-S'i' · ~ l~ c,fd . PA2022-009