Item 9b :- ·-,.. ,,.. ~ }i... ;,5 ::, D. ·!Cl. < ·- ~..... - ... .. fl!! !ii; ~~) ,,_.;.., ''.; ;;'!'':: ,it.- "Cl\ : :) . ~ .. . , ,:..~.; . t; " ·z - ·2 z ,.~· . '.· { MAK CITY ·()f PACIFIC GROVE , •••. ' .v Cornmunity Development Department - Planning Division 3. 00 Forest Avenue, Pacific Grove, CA 93950 Tef: 831.648,3190 • fax: 831.64;8.3.184 • www.cityofpacifi!:grove.org/cedd Permit Applia1tion Appffcation # Date: Total Fees: Received by; }f]" )07 tci -11 1f.1Q7,00 ,l,w,ut o'J.{.aj(or.:!--- Prqj~ctAddress: 804 Eioe Aveoue, eacific GroYe ----- --- APN: 006-327-007-000 Project Description: Owner:is coi:isidei:iAg applyjAg for: a buildiAQ plaAAiAg aAd buildii:::19 per:mit to add additional square footage to their home..Before submitting.ap~lication the Owner would like confirmation that it is not considered historical ,Agglic:ant owner Name: Michael Fletcher Name: Walton Takehara Phone: Phone: Email: Email: wallytak@aol com Mailing Address:. PO Box 154Q Mailing Address: 804 eioe Avenue Pebble Beach, CA 93953 Pacific Grove, CA '\?Jt\ ~D Permit Request: DCRD: Counter Determination DAUP: Administrative UP cy(IHS: Initial HistoricScreening :] AVAR: Administrative VAR :J AP: Architectural Permit 0 UP-A: UP Amendment 0 HPP: Historic Preservation uVAR-A: VARAmendment nAAP: AdministrativeAP 0 AUP-A: AUP Amendmeht 0.A:Appeal :J AVAR-A: AVARAmendment !J AOC: Admjn Design Change DSU: Secood Unit OTPD: TreePermitW/ Dev't DMMP: Mitigation Monitoring iJSP: Sign Permit DLIA: Lot Line Adjustment 0 PUU: Undocumented Unit Ll . Stormwater Permit DUP: Use Per!lllt t, LM: Lot Meraer OVAR: Variance OOther: CEQA Determination: Review Authority: Active Pennits: overlayZones: ~ xempt D Staff ~ RC DActive Planning Permit r: Butterfly zone Ci InitialStudy & Mitigated OZA O PC 0 Active Building Permit fJ Coastal Zone Negative Declaration 67° Area of Special Biological OSPRC DCC O Active Code Violation OEnvironmental Impact DARB 0 Permit#: Significance (ASBS) Report r EnvironmentallySensitive Habitat Area (€SHA} Property Information Lot: \(b 2 1.. O Block: IP 1 Tract: P&Add;-h'C"l ZC: R- \ GP: IW.d. ~ (7,4 d.u-1&\\ Lot Size: ,?,. -se:i I r+ JJ Historic Resources Inventory DArchaeologically SensitiVe Area Staff Use Only: ~ .~ _.;~\Jr 1' ' ... 'fof.D0 +It ·'iD +llt;.rf... 9>5'.2-'I J. I ;-1-l~ - . - ."~ •r• ... \;.,1,-·• OC ~ ! '' ·· -tERTiflCATION - t;"the tinderslgned, under penalty of perjury, depose and certify that I am the applicant for this request, that the property owner approves this application and that all statements contained her.ein, including all documents and plans submitted in connection withthis application. are true and accurate to the best ofmy knowledge. ::=::.i~~~ Date: Date: Updated• 12/2/2015 , OCR Text: Item 9b :- ·-,.. ,,.. ~ }i... ;,5 ::, D. ·!Cl. < ·- ~..... - ... .. fl!! !ii; ~~) ,,_.;.., ''.; ;;'!'':: ,it.- "Cl\ : :) . ~ .. . , ,:..~.; . t; " ·z - ·2 z ,.~· . '.· { MAK CITY ·()f PACIFIC GROVE , •••. ' .v Cornmunity Development Department - Planning Division 3. 00 Forest Avenue, Pacific Grove, CA 93950 Tef: 831.648,3190 • fax: 831.64;8.3.184 • www.cityofpacifi!:grove.org/cedd Permit Applia1tion Appffcation # Date: Total Fees: Received by; }f]" )07 tci -11 1f.1Q7,00 ,l,w,ut o'J.{.aj(or.:!--- Prqj~ctAddress: 804 Eioe Aveoue, eacific GroYe ----- --- APN: 006-327-007-000 Project Description: Owner:is coi:isidei:iAg applyjAg for: a buildiAQ plaAAiAg aAd buildii:::19 per:mit to add additional square footage to their home..Before submitting.ap~lication the Owner would like confirmation that it is not considered historical ,Agglic:ant owner Name: Michael Fletcher Name: Walton Takehara Phone: Phone: Email: Email: wallytak@aol com Mailing Address:. PO Box 154Q Mailing Address: 804 eioe Avenue Pebble Beach, CA 93953 Pacific Grove, CA '\?Jt\ ~D Permit Request: DCRD: Counter Determination DAUP: Administrative UP cy(IHS: Initial HistoricScreening :] AVAR: Administrative VAR :J AP: Architectural Permit 0 UP-A: UP Amendment 0 HPP: Historic Preservation uVAR-A: VARAmendment nAAP: AdministrativeAP 0 AUP-A: AUP Amendmeht 0.A:Appeal :J AVAR-A: AVARAmendment !J AOC: Admjn Design Change DSU: Secood Unit OTPD: TreePermitW/ Dev't DMMP: Mitigation Monitoring iJSP: Sign Permit DLIA: Lot Line Adjustment 0 PUU: Undocumented Unit Ll . Stormwater Permit DUP: Use Per!lllt t, LM: Lot Meraer OVAR: Variance OOther: CEQA Determination: Review Authority: Active Pennits: overlayZones: ~ xempt D Staff ~ RC DActive Planning Permit r: Butterfly zone Ci InitialStudy & Mitigated OZA O PC 0 Active Building Permit fJ Coastal Zone Negative Declaration 67° Area of Special Biological OSPRC DCC O Active Code Violation OEnvironmental Impact DARB 0 Permit#: Significance (ASBS) Report r EnvironmentallySensitive Habitat Area (€SHA} Property Information Lot: \(b 2 1.. O Block: IP 1 Tract: P&Add;-h'C"l ZC: R- \ GP: IW.d. ~ (7,4 d.u-1&\\ Lot Size: ,?,. -se:i I r JJ Historic Resources Inventory DArchaeologically SensitiVe Area Staff Use Only: ~ .~ _.;~\Jr 1' ' ... 'fof.D0 It ·'iD llt;.rf... 9>5'.2-'I J. I ;-1-l~ - . - ."~ •r• ... \;.,1,-·• OC ~ ! '' ·· -tERTiflCATION - t;"the tinderslgned, under penalty of perjury, depose and certify that I am the applicant for this request, that the property owner approves this application and that all statements contained her.ein, including all documents and plans submitted in connection withthis application. are true and accurate to the best ofmy knowledge. ::=::.i~~~ Date: Date: Updated• 12/2/2015 , Heritage Society of Pacific Grove,Historical Collections,Historic Properties of Pacific Grove,Pine,804 Pine,804 Pine Ave IHS_redacted.pdf,804 Pine Ave IHS_redacted.pdf 1 Page 1, Tags: 804 PINE AVE IHS_REDACTED.PDF, 804 Pine Ave IHS_redacted.pdf 1 Page 1