HomeMy WebLinkAbout1204 OAK AVE; ; CBR2021-2037; PermitBuilding Permit Finaled
Residential Permit
Print Date: 08/30/2021
Job Address:
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwelling Units:
Bedrooms:
Bathrooms:
Occupant Load:
Code Edition:
Sprinkled:
Project Title:
1204 OAK AVE, CARLSBAD, CA 9200B-1929
BLDG-Residential Work Class:
1561805000 Track#:
$13,487.90 Lot#:
Project#:
Plan#:
Construction Type:
Orig. Plan Check#:
Plan Check#:
Alteration
Description: 290 SF REMODEL TO CONVERT EXISTING RECROOM INTO TWO BEDROOMS
Applicant:
PETER RODRIGUEZ
1640 OCEANSIDE BLVD
OCEANSIDE, CA 92054-5427
(619) 995-2535
FEE
BUILDING INSPECTION FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Property Owner:
OAK AVENUE VENTURE LLC
1640 OCEANSIDE BLVD
OCEANSIDE, CA 92054
ELECTRICAL BLDG RESIDENTIAL NEW/ADDITION/REMODEL
SB1473 -GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION -RESIDENTIAL (SMIP)
Total Fees: $416.50 Total Payments To Date: $416.50
(city of
Carlsbad
Permit No: CBR2021-2037
Status:
Applied:
Issued:
Finaled Close Out:
Inspector:
Final Inspection:
Balance Due:
Closed -Finaled
07/08/2021
08/04/2021
TKers
08/27/2021
AMOUNT
$117.00
$150.44
$105.31
$41.00
$1.00
$1.75
$0.00
Please take NOTICE that approval of your project includes the "lmposition11 of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these
fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the
protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section
3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their
imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection
fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this
project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
Building Division Page 1 of 1
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
(cicyof
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
8-1
Plan Check (pe7f:-zJ_-2£,3
Est. Value ~'.(,~
PC Deposit
Date ___________,___7 /~~1-Y-/ J---_,_I _ I 7
Job Address 1204 Oak Ave, Carlsbad, CA 82008 Suite:, ____ APN: 150-180-50-00
CT/Project #: __________________ Lot #: ____ Year Built: _2_0_0_9 _______ _
Fire Sprinklers: 0YESQ NO Air Conditioning:Q YES 0 NO
BRIEF DESCRIPTION OF WORK:
Electrical Panel Upgrade: QYEs0 NO
Addition remodel -add two bedrooms to existing Rec Room.
0 Addition/New: ______ Living SF, ____ Deck SF, ____ Patio SF, ____ Garage SF __ _
Is this to create an Accessory Dwelling Unit? OY 0 N New Fireplace? OY 0 N, if yes how many? __
~ Remodel: 290 .SF of affected area Is the area a conversion or change of use ? OY 0 N -----
0 Pool/Spa:. ____ SF Additional Gas or Electrical Features? ____________ _
osolar: ___ KW,. ___ Modules, Mounted:0Roof 0Ground, Tilt: 0 YON, RMA: OY ON,
Battery:OY ON, Panel Upgrade: OY ON
D Reroof: --------------------------------------□ Plumbing/Mechanical/Electrical
0 Only: Other:
This permit is to be issued in the name of the Property Owner as Owner~Builder, licensed contractor or Authorized Agent of the
owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process.
PROPERTY OWNER APPLICANT O PROPERTY OWNERS AUTHORIZED AGENT APPLICANT ~
Name: Oak Avenue Ventures LLC Name: Peter Rodriauez ...;._=:_~==='--------------
Address: 1640 Oceanside Blvd Address: 1640 Oceanside Blvd
City: Oceanside State:_C_A __ ,Zip: 92054 City: Oceanside State:~Zip:_9_20_5_4 __ _
Phone: 858 353-1037 Phone: 619 995-2535
Email: development@beachfrontonlv.com Email: development@beachfrontonlv.com
DESIGN PROFESSIONAL f" APPLICANT □
Name: Po...vl LQ.r1~1r-ro~l'\~-------
Address: 2909 Mesa Orb.ft
City: Oceanside State: CA Zip:_92_0_5_4 __ _
Phone: 760 722-4904
Email: development@beachfrontonly.com
Architect State License: 0 18757 ------------
CONTRACTOR OF RECORD
Name: owner/builder
APPLICANT □
Address: __________________ _
City: ________ .State: ___ .Zip: ______ _
Phone: ___________________ _
Email: ___________________ _
State License/class: ______ ,Bus. License: ____ _
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
REV. 08/20
IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW:
(OPTION A): LICENSED CONTRACTOR DECLARATION:
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect. I also affirm under penalty of perjury one of the
following declarations:
D1 have and will maintain a certificate of consentto self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the
work which this permit is issued. Policy No. ______________________________________ _
DI have and will maintain worker's compensation, as required by Section 3700 oft he Labor Code, forthe performance of the work for which this permit is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name: ____________________ _
Policy No. ____________________________ ,Expiration Date: _______________ _
D Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become
subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to
criminal penalties and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code,
interest and attorney's fees.
CONSTRUCTION LENDING AGENCY. IF ANY:
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name: ____________________ Lender's Address: ____________________ _
CONTRACTOR PRINT: owner/builder SIGN: __________ DATE: ______ _
(OPTION B): OWNER-BUILDER DECLARATION:
f hereby affirm that I am exempt from Contractor's License Law for the following reason:
DI, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
Ii] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
~wner Builder acknowledgement and verification form" has been filled out, signed and attached to this application.
D Owners "Authorized Agent Form" has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner's behalf.
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the
improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder ifit has not been constructed in its entirety by licensed
contractors./ understand that o copy of the applicable low, Section 7044 of the Business and Professions Code, is available upon request when this application is
submitted or at the following Web site: http://www.leginfo.co.gov/colow.html.
SIGN:_~_._/ ______ DATE: _ _,";J-_,/....::2..:::.J/'-2-::....:...( _ OWNER PRINT: __._l3""bk,r-=---"££:dy=::....·l.:.:;'}\i,1-=-<..._.t::_
APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL
By my signature below, I certify that: I am the property owner or State of California Licensed Contractor or authorized to act on the property
owner or contractor's behalf. I certify that I have read the application and state that the above information is correct and that the information on
the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE,
INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE
AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0' deep and
demolition or construction of structures over 3 stories in height.
APPLICANT PRINT: Pe-\u-Rodvlca:ue...c SIGN: ~12----'---_____ DATE: __ -=t--__.__/_2...,_/ 2...--'--( _
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
2 REV. 08/20
Building Permit Inspection History Finaled
(city of
Carlsbad
' '
1 ' ' 's2rs , , , : PERMl'T: INSPECTION HISTORY for {CBR2021-:2037)
Permit Type: BLDG-Residential
Work Class: Alteration
Status: Closed -Finaled
Application Date: 07/08/2021 Owner: OAK AVENUE VENTURE LLC
Issue Date: 08/04/2021 Subdivision:
Expiration Date: 02/22/2022 Address: 1204 OAK AVE
IVR Number: 34507 CARLSBAD, CA 92008-1929
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date
08/23/2021 08/23/2021 BLDG-14 164 765-2021
Frame/Steel/Bolting/We
lding (Decks)
Checklist item
BLDG-Building Deficiency
COMMENTS
08/30/2021 08/27/2021 BLDG-Final Inspection 165200-2021
Monday, August 30, 2021
Checklist Item
BLDG-Building Deficiency
BLOG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
Checklist Item
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
COMMENTS
COMMENTS
Status
Passed Tim Kersch Complete
Passed
Yes
Passed Tim Kersch Complete
Passed
Yes
Yes
Yes
Yes
Yes
Passed
No
No
No
No
No
Page 1 of 1
DATE: 7/26/2021
JURISDICTION: Carlsbad
PLAN CHECK#.: CB-CBR2021-2037
PROJECT ADDRESS: 1204 Oak Ave.
PROJECT NAME: Bedroom Addition
• nv
INTERWEST
□ APPLICANT
□ JURIS.
SETI
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
~ The plans transmitted herewith will substantially comply with the jurisdiction's codes
when minor deficiencies identified below are resolved and checked by building department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at lnterwest
until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
D lnterwest staff did not advise the applicant that the plan check has been completed.
D lnterwest staff did advise the applicant that the plan check has been completed.
Person contacted:
Date contacted: (by:
Telephone#:
) Email:
Mail Telephone Fax In Person
REMARKS: Add note to provide½" gap at detail 1/A-1 where~k is indicated on second
copy of approved plans -, \
By: Scott Harris
lnterwest
7/12/2021
Enclosures:
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
Carlsbad CB-CBR2021-2037
7/26/2021
PLAN REVIEW CORRECTION LIST
SINGLE FAMILY DWELLINGS AND DUPLEXES
PLAN CHECK#.: CB-CBR2021-2037 JURISDICTION: Carlsbad
PROJECT ADDRESS: 1204 Oak Ave.
FLOOR AREA: 300sf
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION:
DATE INITIAL PLAN REVIEW
COMPLETED: 7/26/2021
FOREWORD (PLEASE READ):
STORIES: 2
HEIGHT: 25 feet
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 7/12/2021
PLAN REVIEWER: Scott Harris
This plan review is limited to the technical requirements contained in the California Residential
Code, California Building Code, California Plumbing Code, California Mechanical Code,
California I Electrical Code and state laws regulating energy conservation, noise attenuation and
access for the disabled. This plan review is based on regulations enforced by the Building
Department. You may have other corrections based on laws and ordinance by the Planning
Department, Engineering Department, Fire Department or other departments. Clearance from
those departments may be required prior to the issuance of a building permit.
Present California law mandates that construction comply with the 2019 edition of the California
Code of Regulations (Title 24), which adopts the following model codes: 2019 CRC, 2019 CBC,
2019 CPC, 2019 CMC and 2019 CEC.
The above regulations apply, regardless of the code editions adopted by ordinance.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 105.4 of
the 2019 California Building Code, the approval of the plans does not permit the violation of any
state, county or city law.
To speed up the recheck process, please note on this list /or a copy) where each
correction item has been addressed, i.e., plan sheet number, specification section, etc.
Be sure to enclose the marked up list when you submit the revised plans.
' .
Carlsbad CB-CBR2021-2037
7/26/2021
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad PLAN CHECK#.: CB-CBR2021-2037
PREPARED BY: Scott Harris
BUILDING ADDRESS: 1204 Oak Ave.
BUILDING OCCUPANCY: R-3
BUILDING AREA Valuation
PORTION ( Sq. Ft) Multiplier
Bedroom remod1 300 73.96
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
19" C "ldin P rm· Fee / 9, UB Bui g e 1t ...
I 1997 UBC Plan Check Fee ~
Type of Review: ,., Complete Review
' Other r Repetitive Fee ~
1 ,..1 Repeats r Hourly
EsGil Fee
~ ~
DATE: 7/26/2021
Reg. VALUE ($)
Mod.
22,188
22,188
7
' Structural Only
]Hr@*
$149.4~
Comments: In addition to the above fee, an additional fee of$ is due ( hour@
$ /hr.) for the CalGreen review.
Sheet of
( City of
Carlsbad
PURPOSE
CLIMATE ACTION PLAN
CONSISTENCY CHECKLIST
B-50
Development Services
Building Division
1635 Faraday Avenue
(760) 602-2719
www.carlsbadca.gov
This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance
requirements apply to their projects. The completed checklist must be included in the building permit application. It may be
necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate
full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach
to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as
specified by the ordinances.
NOTE: The following type of permits are not required to fill out this form
❖ Patio I ❖ Decks I ❖ PME (w/o panel upgrade) I ❖ Pool
-"' If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance,
an explanation must be provided to the satisfaction of the Building Official.
..11111 Details on CAP ordinance requirements are available on the city's website.
-"' A CAP Building Plan template (form B-55) shall be added to the title page all building plans. This template shall be
completed to demonstrate project compliance with the CAP ordinances. Refer to the building application webpage and
download the latest form.
Project Name/Building
Permit No. Remodel -Room Addition BP No. Cfc}R.Z.021-2.!Jj+
Property Address/APN: 150-180-50-00
Applicant Name/Co.: Peter Rodriguez for
Applicant Address 1640 Oceanside Blvd Oceanside, CA 92054
Contact Phone: 619-995-2535 Contact Email: development@beachfrontonly.com
Contact information of person completing this checklist (if different than above):
Name:
Company
name/address:
same Contact Phone:
Contact Email
Applicant Signature: __ -1.JZ-,--_____________ Date: __ '9--_/_i-~/_z.._l __ _
8-50 Page 1 of6 Revised 06/18
( City of
Carlsbad
OWNER-BUILDER
ACKNOWLEDGEMENT
FORM
8-61
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www .carlsbadca.gov
OWNER-BUILDER ACKNOWLEDGMENT FORM
Pursuant to State af California Health and Safety Code Section 19825-19829
To: Property Owner
An application for construction permit(s) has been submitted in your name listing you as the owner-builder of the
property located at:
Site Address 1204 Oak Ave, carlsbad, ca 92008
The City of Carlsbad ("City") is providing you with this Owner-Builder Acknowledgment and Verification form
to inform you of the responsibilities and the possible risks associated with typical construction activities issued
in your name as the Owner-Builder.
The City will not issue a construction permit until you have read and initialed your understanding of each
provision in the Property Owner Acknowledgment section below and sign the form. An agent of the owner
cannot execute this notice unless you, the property owner, complete the Owner's Authorized Agent form and
it is accepted by the City of Carlsbad.
INSTRUCTIONS: Please read and initial each statement below to acknowledge your understanding and
verification of this information by signature at the bottom of the form. These are very important construction
related acknowledgments designed to inform the property owner of his/her obligations related to the requested
permit activities.
I. ~I understand a frequent practice of unlicensed contractors is to have the property owner obtain an "Owner·
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. l, as an Owner-"Builder, may be held liable and subject to serious financial risk for any injuries
sustained by an unlicensed contractor and his or her employees while working on my property. My homeowner's
insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of
the limits of my insurance coverage for injuries to workers on my property.
II. ~I understand building permits are not required to be signed by property owners unless they are responsible
for the construction and are not hiring a licensed contractor to assume this responsibility.
Ill. PR I understand as an "Owner-Builder" tam the responsible party of record on the permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his
or her name instead of my own.
IV. PR I understand contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
V. _E_B_1 understand if I employ or otherwise engage any persons, other than California licensed contractors, and
the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be
considered an "employer" under state and federal law.
1 REV. 08/20
Owner-Builder Acknowledgement Continued
VI. J:..!2_1 understand if I am considered an "employer" under state and federal law, I must register with the state
and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute to unemployment compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
VII. PR I understand under California Contractors' State License Law, an Owner-Builder who builds single., family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building contractor.
VIII. ~ I understand as an Owner-·Builder if I sell the property for which this permit is issued, I may be held liable
for any financial or personal injuries sustained by any subsequent owner(s) which result from any latent
construction defects in the workmanship or materials.
IX. ~ I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at l-800-321-CSLB (2752) or www.cslb.ca.gov for more information
about licensed contractors.
X. ~I am aware of and consent to an Owner--Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
1204 Oak Ave, Carlsbad, CA 92008
XI. J:..!2_1 agree that, as the party legally and financially responsible forth is proposed construction activity, I will abide
by all applicable laws and requirements that govern Owner-Builders as well as employers.
XII. J:..!2_1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form.
Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who
does not have a license, the Contractor's State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court.
It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm
is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-
Builder and wish to hire contractors, you will be responsible for verifying whether or not those contractors are
properly licensed and the status of their workers' compensation coverage.
Before a building permit can be issued, this form must be completed, signed by the property owner and returned
to the City of Carlsbad Building Division.
I dee/ore under penalty of perjury that I have read and understand all of the information provided on this form and that my responses, including my
authority to sign this form, is true and correct. I am aware that I have the option to consult with legal counsel prior to signing this form, and I hove
either (1) consulted with legal counsel prior to signing this form or (2) have waived this right in signing this form without the advice of legal counsel.
Peter Rodriguez
Property Owner Name (PRINT)
~
Property Owner Signature
3-/z/zt
Oat
2 REV. 08/20
{ City of
Carlsbad
OWNERS
AUTHORIZED
AGENT FORM
8-62
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www .carlsbadca.gov
OWNER'SAUTHORIZED AGENT FORM
Only a property owner, contractor or their authorized agent may submit plans and applications for building
permits. To authorize a third-party agent to sign for a building permit, the owner's third party agent must bring
this signed form, which identifies the agent and the owner who s/he is representing, and for what jobs s/he
may obtain permits. The form must be completed in its entirety to be accepted by the City for each separate
permit application.
Note: The following Owners Authorized Agent form is required to be completed by the
property owner only when designating an agent to apply for a construction permit
on his/her behalf.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Property Owner Acknowledgement, the execution of which I understand is my personal responsibility,
I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary
to obtain an Owner-Builder Permit for my project.
IC . . 1 0 . . 1 kl Remodel Scope o onstruct1on ProJect or escnpt1on o Wor : ____________________ _
1204 Oak Ave, Carlsbad, CA 92008 Project Location or Address: _____________________________ _
Name of Authorized Agent: _P_e_te_r_R_o_d_r_i_g_u_e_z ____ Tel No. _8_5_8_3_5_3_-_1_0_3_7_
bl// lil\5 7,~3~
AddressofAuthorizedAgent: 1640 Oceanside Blvd
Oceanside, CA 92054
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy.
Property Owner's Signature: ____ _,,;c?--,_ _______________ Date:
Minutes of Meeting of Members
Of
Oak Avenue Venture, LLC
Agent Authorization for Permits with City of Carlsbad
A special meeting of the members of Oak A venue Venture, LLC was held at 1640
Oceanside Blvd, Oceanside, Ca 92054 on the 23,d day of June, 2021, pursuant to a
consent to and waiver of notice of the time, place and purpose of the meeting signed by
all members.
All of the members were present for the meeting and Adele Fischbach acted as Manager
of the meeting.
It has come to the attention of the members of Oak Avenue Venture, LLC that a permit
from The City of Carlsbad would be in the best interest of the Company.
It was considered and approved by all members that Oak Avenue Venture,
LLC would authorize as it's agent, Peter Rodriguez to represent and sign
all documents necessary to obtain permits from the City of Carlsbad.
There being no other matters coming before the members this meeting was
adjourned.
Oak Avenue Venture LLC By:
Manager