HomeMy WebLinkAboutPA2022-0206_20220920_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit -
D Waiver for De Minimis Development D Seasonal D < 90 day D >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 {i) Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
512 Marguerite Ave., Corona Del Mar, CA 92625 / 459-203-07
20ft Ft!"~<, \\,"kz_ff1<$2L#
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
□Tract Map
D Traffic Study
D Use Permit -□Minor []Conditional
D Amendment to existing Use Permit
D Variance
D Amendment -Icade I PC I GP I LC
D Other:
3. Project Description and Justification (Attach additional sheets if necessary):
Create a parcel map for condominium purposes.
4. Applicant/Company Name [:::F=ork==ert==E=ng=i=ne=e=ri=n=g =&=S=u=rv=e=y=in=g=, l=n=c·=============:;-------;::::::::========~'
Mailing Address 122311 Brookhurst St. Ste. 203 Suite/Unit ~I :=::====:=:::=:::::,I
City !Huntington Beach State ,_lc_A,::=======-'~Z~i!"p:...::I9=2=6=4=6======'
Phone 1714 963-6793 I I I Fax ,......_ ____ __, Email .,___ __________ ____.
5 C t tic N !Thomas E. Decker I
. on ac ompany!,...:...~a~m:..:..:::.e-===================:;-----~=======:::;'·
Mailing Address 122311 Brookhurst St. Ste. 203 Suite/Unit ';:::I2=03:=:::=:::=:::=::=:',I
City !Huntington Beach StatP-!cA I Zip 192646 I
Phone 1114 963-6793 Ext. 244 Fax ._I ______ .....,I Email jtomd@forkertengineering.com I
6. Owner Name ~LA-;:::::2=1=G=, =L=LC:=::, a:=::C=a=lif=o=rn=ia:=::L=im=it=e=d=L=ia=b=il=ity'.:::::=C=o::::'.:rp=o=ra=t=io=n:=:::=::=.------~=-=-=---~~=--=--:=::--=--=t-
1 I
100
M •1• Add 26880 Aliso Viejo Pkwy S ·t /U ·t a1 mg ress ~-----------------~ ________________ ~ ___ u_1_.e m ';:.-=.-=--=--=--=--=--=--=--=--=--=--::::'.,
C • !Aliso Viejo ]cA I ~ 192656 1ty ate ~----;:::::=:::=:::=:::=:::=:::::'....· ~;J.Jl..==-=-=-=-=-=-=-=-=-=='
Ph 1949 894-8034 j one -Fax Email _mrosene@tjhus_a._co_m ________ __,
7. Property Owner's Affidavit*: (I) (>Ne) ..._I _M_a_rk_R_o_s_e_n_e_l_A_u_th_o_r_iz_e_d_S_ig_n_e_r ____________ ....,
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (>Ne) 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): ~Z ____. Title: lgc..., 'n~pl,.JJoate: I~. \t. ·ZL I
DD/MO/YEAR
Signature(s): ______________ _ Title:~----__..] Date: I 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.
F:\Users\CDD\Shared\Admin\Plannin9...Division\Applications\Application_Guidelines\Planning Permit Application -CDP added.docx Rev: 01/24/17
PA2022-0206
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:
________________________________________________________________________________________
ACKNOWLEDGMENT
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 O ss. ~ __ , ,1
On <t.o . , 20.a.J._ before me, tlf). fr'Qnill "'--fa.MS ,
Notary P lie, personally appeared tJo CK G Df,e &: , who
proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct. ft • ft ft • ft O ft l l<A7HRYM FRAIICO KRAUS
. :o.otary Public • California "' WITNESS my hand and official seal.
ACKNOWLEDGMENT
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 _________ _, ss.
On ___________ , 20 __ before me,
; Orange County !:
Commission:/ 2385'493
.Y.y Comm. Expires Dec 6, 2025
(seal)
Notary Public, personally appeared _____________________ ,
proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature (seal)
PA2022-0206
1
ACTION BY UNANIMOUS WRITTEN CONSENT OF
THE MANAGERS OF
LA21G, LLC
March 9, 2022 The undersigned, being all of the managers (the “Managers”) of LA21G, LLC, a California limited liability company (the “Company”), pursuant to Section 17704.07(n)(1) of the California
Revised Uniform Limited Liability Company Act and the Limited Liability Company Agreement
of the Company, dated as of November 27, 2020 (the “LLC Agreement”), hereby consent to, adopt and approve the following resolutions. Capitalized terms used but not defined in this Unanimous Written Consent shall have the meanings ascribed thereto in the LLC Agreement.
WHEREAS, the Managers desire to designate Mark Rosene as an authorized agent acting
on behalf of the Company to execute and deliver any and all instruments or other documents required to be executed by the Company, other than grant deeds. NOW, THEREFORE, BE IT RESOLVED, that, subject to the terms of this Action by
Unanimous Written Consent, Mark Rosene (the “Authorized Agent”) is hereby authorized and
empowered, on behalf of the Company, to execute, deliver and perform all instruments and other documents, other than grant deeds, required to be executed by the Company, including without limit any agreement (including lease agreements, security agreements, and guaranties), assignment, document, instrument, certificate, acknowledgments or statement required to be
executed, delivered and performed by the Company, and the taking of such actions or the execution
of such document to be conclusive evidence of the necessity or desirability thereof. RESOLVED FURTHER, that the officers of the Company are hereby authorized to do or to cause to be done any and all other acts and things as such officer may in their discretion deem
necessary or appropriate to carry out the purposes of the foregoing resolutions.
RESOLVED FURTHER, that all prior actions of the Authorized Agent, Managers or any officer of the Company taken prior to the date hereof in connection with the foregoing are hereby ratified, confirmed and approved as the acts and deeds of the Company.
RESOLVED FURTHER, that officers of the Company are hereby authorized and empowered, on behalf of and in the name of the Company, to certify from time to time the adoption of the foregoing resolutions.
This Action by Unanimous Written Consent may be executed in two or more counterparts,
including by facsimile transmission or electronic transmission of .pdf files, each of which shall be deemed an original for all purposes and together shall constitute one and the same action by unanimous written consent.
[Signature page follows]
DocuSign Envelope ID: 432A10D7-A4C6-4E50-AB05-90EB973AC70B
[Signature Page to Action by Unanimous Written Consent of the Managers of LA21G, LLC]
This Action by Unanimous Written Consent is executed effective as of the date first written above.
__________________________________ Thomas Beadel
TJH SoCal, LLC, a California limited liability company By: Thomas James Homes, LLC,
a Delaware limited liability company,
its Sole Member By: ______________________________
Name: Thomas Beadel
Title: Chief Executive Officer
DocuSign Envelope ID: 432A10D7-A4C6-4E50-AB05-90EB973AC70B