HomeMy WebLinkAboutRP 05-03X1; SPRINGHILL SUITES CARLSBAD; Redevelopment Permits (RP)CARLSBAD REDEVELOPMENT AGENCY
PERMIT APPLICATION
PLEASE CHECK ALL THAT APPLY:
I I ADMINISTRATIVE PERMIT
•
•
•
•
•
•
New construction of building(s) or
addition(s) to the building footprint which
have a building permit valuation which is
equal to or less than $60,000.
Interior or exterior improvements to existing
structures which result in an intensity of
use.
Provisional land uses, where a minor or
major redevelopment permit is not
required.
Changes in permitted land uses which
result in site changes, increased ADT,
increased parking requirements, or result
in compatibility issues/problems.
Signs for existing businesses or facilities.
Repair or maintenance activities which are
not exempt from obtaining a permit.
• COASTAL DEVELOPMENT PERMIT
MAJOR REDEVELOPMENT PERMIT
•
•
New construction of building(s) or
addition(s) to the building footprint which
have a building permit valuation which is
greater than $150,000.
Variances for projects within this category.
• MINOR REDEVELOPMENT PERMIT
I I New construction of building(s) or
addition(s) to the building footprint which
have a building permit valuation which is
greater than $60,000 but less than
$150,000.
I I Variances for projects within this category.
I I Variances for projects which would
otherwise be exempt or be eligible for an
administrative permit.
MISCELLANEOUS REDEVELOPMENT PERMIT
• A-Frame Sign
Sign Permit
Sign Program
Sidewalk Tables/Chairs
Outdoor Displays
Other ^^^c3^£.2SS£i^2±2£2to5/__^
PROJECT TITLE:
Brief description of project:
X7 Property Location:
APN(s)::^f^_:
SC. V^crrtu LuC
Owner's Name UlI^^At^cw . ^TS--,^ /
Address Sr^:> <-^!u^^^ ^ sa^ , :;^./^/
Telephone Number ^X^^ - ^ -
-rue ADIZA DCI
.Street Address^/IS<^ <Z^r'Ai:x>^ L(y<J
Applicant's Name CSg^^'^;-
Address :-^r--^<c^ C^n>^/e>o cZ,r^<U^^ . sL 'ZJ<-/
Telephone Number - ^2^7 "
THE AREA BELOW IS TO BE COMPLETED BY CITY STAFF
FEES FOR APPLICATION PROCESSING:
(List type of fee and amount) ^ ^
\crr/\L-
RECEIPT OF APPLICATION
Date Application Received, 10
Application Received by jfi/sf/iJ S/L^4
Permit Number Assigned I^P 0^ • /^^ ^ (f^'/^V /
^0? a^'^^/yf
LAND USE REVIEW DeVe 10oment Servicp'-
Planning Oepartment
1635 Faraday Avenue CARLSBAD APPLICATION
DeVe 10oment Servicp'-
Planning Oepartment
1635 Faraday Avenue CARLSBAD P-1 (760) 602-4610 P-1 www.carlsbadca.gov
APPLICATIONS APPLIED FOR: (CHECK BOXES)
Development Permit (FOR DEPT. USE ONLY) Legislative Permits
I I Administrative Permit
^ Coastal Development Permit (*) OMinor
(FOR DEPT. USE ONLY)
Conditional Use Permit (*)
OMinor O Extension
I I Environmental Impact Assessment
I I Habitat Management Permit O Minor
Hillside Development Permit (*)
Planned Development Permit
O Residential O Non-Residential
I I Planned Industrial Permit
1 I Planning Commission Detemiination
Q Site Development Plan
I I Special Use Permit
I I Tentative Tract Map
I I Variance I I Administrative
04,-
I I General Plan Amendment
I I Local Coastal Program Amendment (*)
I I Master Plan | | Amendment
I I Specific Plan I I Amendment
I I Zone Change (*)
I I Zone Code Amendment
Ust other apollcations not specified
•
•
•
(*) = eligible for 25% discount
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICAnONS BE FILEO, MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING
ONLY ONE APPLICAnON BE FILED. MUST BE SUBMITTED PRIOR TO 4:00 P.M.
ASSESSOR PARCEL NO(S).: ^ ^;,
PROJECTNAME: . ,
BRIEF DESCRIPTION OF PROJECT: - , * ' . s ... . .J t • -1^ • / r , y
. -r- ... .i • ./c-, •'••» N
y • '
' ^ i . . . ., , ,-
BRIEF LEGAL DESCRIPTION: y
LOCATION OF PROJECT: / ;,r ^ \
STREET ADDRESS
ON THE: SIDE OF
(NORTH, SOUTH, EAST. WEST)
BETWEEN ,f^41-.- y..:^^ AND
(NAME OF STREET)
(NAME OF STREET)
(NAME OF STREET)
P-1 Page 1 of 5 Revised 01/10
OWNER NAME (Print):^:
MAILING ADDRESS:
CITY. STATE. ZIP:
TELEPHONE:
EMAIL ADDRESS: %
APPLICANT NAME (Print):
MAILING ADDRESS:
CITY. STATE. ZIP:
TELEPHONE: .
EMAILADDRESS: .
I CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE
iNFORMATION IS; TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE. , /
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER
AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO
THE BEST OF MY KN(3WLEDGE.
SIGNATURE DATE SIGNATURE
3>l nl'^^o
DATE
APPLICANTS REPRESENTATIVE (Print):
MAILING ADDRESS:
CITY. STATE.ZIP: ; ^ r
TELEPHONE:
EMAILADDRESS:
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT TO THE BESTX)F MY KNOWLEDGE. RECT TO THE BEST^ MY Kl
3//-t-/2^^
SIGNATURE DATE
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF. PLANNING
COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS
APPLICATION. lAA^E CONSENT TO ENTRY FOR THIS PURPOSE.
NOTiCE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING
RECORDED ON THE T^TLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLiCANT NOTICE OF RESTRICTIONS RUN WITH
THE LAND AND BINDj^NY SUCCESSORS IN INTEREST.
"PR^P^TYOVI NER SiGNATURE
FOR CITY USE ONLY
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
P-1 Page 2 of 5 Revised 01/10
DISCLOSURE Development Services
<S«^ STATEIWIENT Planning Department
CITY OF P- 1635 Faraday Avenue
'\^/ (760)602-4610
www.carlsbadca.gov CAR L.SBAI3
Applicanfs statement or disclosure of certain ownership interests on all applications which will
require discretionary action on the part ofthe City Council or any appointed Board, Commission
or Committee.
The following information MUST be disclosed at the time of application submittal. Your project
cannot be reviewed until this information is completed. Please print.
Note:
Person is defined as "Any individual, firm, co-partnership, joint venture, association, social club, fraternal
organization, corporation, estate, trust, receiver, syndicate, in this and any other county, city and county,
city municipality, district or other political subdivision or any other group or combination acting as a unit."
Agents may sign this document; however, the legal name and entity of the applicant and property owner
must be provided below.
1. APPLICANT (Not the applicant's agent)
Provide the COMPLETE. LEGAL names and addresses of ALL persons having a
financial interest in the application. If the applicant includes a corporation or ipartnership.
include the names, titles, addresses of all individuals owning more than 10% of the
shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE
INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publiclv-owned
corporation, include the names, titles, and addresses of the corporate officers. (A
separate page may be attached if necessary.)
Person i^^/^A/^ PAT^L Corp/Part ^'^^ ^^'^ r UC / Of<^ ^tmCP
Title AyAA//AGa? Title o^Aje^
Address GOtDcsV CtflCU S'TF 2/</ Address &0COe/v Ci/icCt Sie 2/V
OWNER (Not the owner's agent)
Provide the COMPLETE. LEGAL names and addresses of ALL persons having any
ownership interest in the property involved. Also, provide the nature of the legal
ownership (i.e., partnership, tenants in common, non-profit, corporation, etc.). If the
ownership includes a corporation or partnership, include the names, titles, addresses of
all individuals owning more than 10% ofthe shares. IF NO INDIVIDUALS OWN MORE
THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE
SPACE BELOW. If a publiclv-owned corporation, include the names, titles, and
addresses of the coiporate officers. (A separate page may be attached if necessary.)
Person O^^^A&^t RAre^ ^ Corp/Part -
Title ^ Title OMjm
Address ^ 6OLDB\J Clf^CUe 2/^ Address ^ ^^Oe^ Cl/^lX S7^ 2/</
P-1 (A) Page lof 2 Revised 04/09
NON-PROFIT ORGANIZATION OR TRUST
If any person identified pursuant to (1) or (2) above is a nonprofit orqanization or a trust,
list the names and addresses of ANY person serving as an officer or director of the non-
profit organization or as trustee or beneficiary of the.
Non Profit/Trust.
Title
Non Profit/Trust
Title
Address Address
4. Have you had more than $500 worth of business transacted with any member of City
staff. Boards, Commissions, Committees and/or Council within the past twelve (12)
months?
I I Yes [3^0 Ifyes, please indicate person(s):
NOTE: Attach additional sheets if necessary.
I certify that all the above information is true and correct to the best of my knowledge.
Signature of owner/date
9C H^TBl , LLC
Print or type name of owner
Signature of applicant/date
/f67^ ^ lie j D(CAJ -HOTtrtS
Print or type name of applicant
Signature of owner/applicant's agent if applicable/date
Print or type name of owner/applicant's agent
p-1 (A) Page 2 of 2 Revised 04/09