HomeMy WebLinkAboutPA2022-0237_20221019_ApplicationDocuSign Envelope ID: 417FBE10-5872-455D-8E16-F226112C2DF8 ,t Department
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~ ~-···w 2 Planning Permit Application
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100 C1v1c Center Dnve
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
1. Check Permits Requested:
0 Approval-in-Concept -AIC # 0 Lot Merger ~ Coastal Development Permit O Limited Term Permit -
0 Waiver for De Minimis Development O Seasonal O < 90 day 0 >90 days
0 Coastal Residential Development O Modification Permit
0 Staff Approval
0 Tract Map
0 Traffic Study
0 Use Permit -□Minor □conditional
0 Condominium Conversion O Off-Site Parking Agreement
0 Comprehensive Sign Program O Planned Community Development Plan
0 Amendment to existing Use Permit
0 Variance
0 Development Agreement O Planned Development Permit 0 Amendment -□Code □PC □GP 0LCP
0 Other: 0 Development Plan O Site Development Review -D Major D Minor
0 Lot Line Adjustment O Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
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3. Project Description and Justification (Attach additional sheets if necessary):
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4. ApplicanUCompany Name I :P~ ' ( fd J00V\ 0 7 C) fJc I
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Mailing Address I •,;.,,J'0 U · c-i fl A:ve-, I Suite/Unit J';::::======;===I
City I 4w ~ (1 (I ~-c Vi. ( State I r /.{" I Zip I I
Phone 1 , t. {j;--i c, -'1 LfhC6 Fax ~I -----~I Email J rc.C\ ·-/ :pc j
Contact/Company Name I Cl C, \Jro V'\
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Mailing Address -City State
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Property Owner Name I /2151.,, I L,. L. C .:..=.:.:..::..======:;:::=::=:====:'.::=================;----;::=:...._===-===---====]
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City I State I I Zip I I ,,-.
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Fax I -I Email Phone
* I 2252 Mesa Drive, LLC, by Gary Jabara 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): [~:•Ao Title: j Manager ] Date: 1 9/112022 _;
MM/DDNEAR
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 ParcelfTract Map and Lot Line Adjustment Application must be notarized .
PA2022-0237
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:
________________________________________________________________________________________
DocuSign Envelope ID : 417FBE10-5872-455D-BE16-F226112C2DFB
AUTHORIZED AGENT
DATE:
TO:
RE:
08/22/2022
Whom it may concern
2252 Mesa Drive
To whom it may concern,
I am the owner of the above referenced property, and I do hereby authorize Phil
Edmondson of Pacific Coast Architects to act as my authorized agent for business
concerning my above referenced property.
Respectfully submitted,
I.DocuSigned by:
L~14AD.
Gary Jabara
PA2022-0237