HomeMy WebLinkAboutPA2022-050_20220228_ApplicationCommunity Development Department
Planning Permit Application
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
I:\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_Guidelines\Planning Permit Application_2021.docx Rev: 01/24/17
1.Check Permits Requested:
Approval-in-Concept -AIC # Lot Merger Staff Approval
Coastal Development Permit Limited Term Permit - Tract Map
Waiver for De Minimis Development Seasonal < 90 day >90 days Traffic Study
Coastal Residential Development Modification Permit Use Permit -Minor Conditional
Condominium Conversion Off-Site Parking Agreement Amendment to existing Use Permit
Comprehensive Sign Program Planned Community Development Plan Variance
Development Agreement Planned Development Permit Amendment -Code PC GP LCP
Development Plan Site Development Review - Major Minor Other:
Lot Line Adjustment Parcel Map
2.Project Address(es)/Assessor’s Parcel No(s)
3.Project Description and Justification (Attach additional sheets if necessary):
4.Applicant/Company Name
Mailing Address Suite/Unit
City State Zip
Phone Fax Email
5.Contact/Company Name
Mailing Address Suite/Unit
City State Zip
Phone Fax Email
6.Property Owner Name
Mailing Address Suite/Unit
City State Zip
Phone Fax 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.
Signature(s): ________________________________ Title: Date:
MM/DD/YEAR
Signature(s): ________________________________ Title: 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.
PA2022-050
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:
________________________________________________________________________________________
PA2022-050