HomeMy WebLinkAbout1047 SAGEBRUSH RD; ; CBR2020-2781; PermitBuilding Permit Finaled
Residential Permit
Print Date: 09/07/2021
Job Address: 1047 SAGEBRUSH RD, CARLSBAD, CA 92011-3974
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwelling Units:
Bedrooms:
Bathrooms:
Occupant Load:
Code Edition:
Sprinkled:
Project Title:
BLDG-Residential
2146441800
$4,691.33
Work Class: Alteration
Track#:
Lot#:
Project#:
Plan#:
Construction Type:
Orig. Plan Check#:
Plan Check#:
Description: ELDRIDGE: 192 SF FOR (2) CANTINA DOORS// REMOVE 4 WINDOWS AND 2 DOORS
Applicant:
JIM LORD CONSTRUCTION
JAMES LORD
574 HYGEIA AVE
ENCINITAS, CA 92024-2601
(760) 803-2260
FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Property Owner:
OWNER ELDRIDGE TOMMIE D AND IRIS S
1047 SAGEBRUSH RD
CARLSBAD, CA 92011
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-RESIDENTIAL
Total Fees: $121.65 Total Payments To Date: $121.65
(city of
Carlsbad
Permit No: CBR2020-2781
Status:
Applied:
Issued:
Finaled Close Out:
Closed -Finaled
10/28/2020
12/03/2020
Inspector: PBurn
Final Inspection: 09/07/2021
Balance Due:
AMOUNT
$70.61
$49.43
$1.00
$0.61
$0.00
Please take NOTICE that approval of your project includes the 11 lmposition11 of fees1 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
~ C:ityof
c::arlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
B-1
Job Address 1047 Sagebrush Rd Suite: ____ .APN: 214-644-18-00
CT/Project #: _________________ Lot#: 188 Year Built: .;;2:.:0;..;0:;..4:._ _____ _
Fire Sprinklers: ()vEs@No Air Conditioning:(!) YES ONO Electrical Panel Upgrnde:QYES(!) NO
fjf!l!T DFSCklP rmN OF WORI(:
Remove 4 existing windows and 2 existing doors. Add appropriate sized headers for 2 w12'x8' openings. Install 2 new 12' x 6' La Cantina doors.
w• '" ~• ~" '' •""' '"'"""••••~w ,-~=•,w-,
Addition/New: ______ Uving SF, ____ Deck SF, ____ Patio SF, ____ ,.Garage SF
Is this to create an Accessory Dwelling Unit'? OY ON New Fireplace? OY ON, if yes how many?
SF of aftected area ls the area a conversion or change of use'? OY 0N ·2
Pool/Spa: _____ .SF Additional Gas or Electrical Featurns? ------·-------
r·7solar: ___ KW, ___ Modules, Mounted:ORoof OGround, Tilt:OvO N, RMA: Ov ON,
Battery:OY ON, Panel Upgrade: Ov ON
Re roof: __________________________________ _
[J Plumbing/Mechanical/Electrical
[. ] Only: Other:
This permit Is to be issued In the name of the Property Owner as Owner~Bullder, licensed contractor or Authorized Agent of the
owner or contractor. The per.son listed as the Applicant below wilt be the main point of contact throughout the permit process.
PIWl'IJ!TY OWNER
Name: Dean Eldridge
APPLICANi PROPERTY OWNEl<S /.IUHIOHIZHI I\GFNT
Name: James Lord
APPIJCJ\Nl Iii
Address: 1047 Sagebrush Rd. Address: _s_74_H;.:yg:..e_ia_A_v_e _____________ _
City: Carlsbad State: CA Zip: 92011 City: Encinitas State: CA __ Zip:_9_2_02_4 __ _
Phone: 7 60 •· ,s-ys--Z 2.o 2.-( 5-3s-• 73iyf Phone: _76_o_s_o3_2_2s_o _____________ _
Email: D l".<1 P • i:..''l cl r 1<\ 'I <1.. (c'. 11 x D ,cl d·,o>~Email: _L;co;:;.r;.;d;;,;J;.;im=@.:.·w:P,cr:::.oc:d"iQ"'Y'-'."'nc:e.c.t __________ _
/,l,'l~><1c,1ftc•1S,CCt,'-<\,v ,.,_.,_ 7
DESIGN f'HOFP;SIONAt
Name: James Lord
f\l'!'UC!\f"T
Address: _______ _,_ ________ _
City: ______ ~ __ _.Zip: ____ _
Phone: ______ _,<----------
Email: ______ .,,._ _________ _
Architect State Ucens11i _________ ,
I
CON'lllACTOR OF llECOHD
Name: James Lord
Al'PUC/\NT I ·1
Address:_s_am_e ________________ _
City: ________ state: ___ .Zip: ______ _
Phone: __________________ _
Email: ___________________ _
State license/ class: B788597 Bus. license: BLOS1243678
/ 163') Fauiday Ave Cl7d, (A 9?008 Ph: J6tH)OJ.-7/JIJ FaA: /fiO-GilJ·/1\'.il:l
'btctVI., /;it d ,.'J(f,Q.. <:..: c'f. t ccl ,· ~·io·c.. c,n..<1,_.,.,."' "' ~,, t' ~ .. ,, , cc'"'' HEV. 08/20
ii; j i
of /'lie lh1:,1nr,>::.~ and r'ro('e ,_,;/(,fl'> rndc, und !i!Y lkensc 15 in /i.:i/ [Prr:c ancl ejfcci. J a!~o
foi/01,:,1im; dcc!orDiio11\·
L J1 have and will m.iintnm w rnnifa:;1tl' (if t.<11N,11t tc sdt•irmm, for work.::rs' wmpi>n<:,ition provided bv ::ir.,nion 310D oftht' tab,1r (ode, for the perfornioi'1n' of 1lw
work which this penn,t b b<.,11NI. Polky N<i..
!jJ I have ,md will maintain worker's compenss1tion. a:. requirt'd by $(1ct1011 3/0tJ of the Laho1 Code, for ttie pe1forrnarice of tlw work frn which ti11\ p01w1it is isstwd.
My workers' compcn~allon i11surann.' r,1rrinr i.lOd policy ntnnbtr· aw: lnsurant:P.Company Name: St1t<.> hm,I C,;nv<'""atin" ~•:<>.a,,,,c,,
Policy No.JJ;i08690 . ---f:l(pfrntion 0,lte: _,_,1_1/_r11_, 1 __________ _
/ ···; Ce1tific<Jtt (Jr [;,:e10ptim1; f cntify that in the pel'for ri1.v1u, of the wo1 k fm v;hid1 this prrrnit Is io'>ued,; shalt !lf)t ;,mplny dUV p~1c,ori in <HlY llli111111;1 ',c il¼ to !wrnriw
~ubJ(:rt to th0 worke(s' comnensrt\!or1 Law~ of C<:1li/orni,1, WARNING: Faih1re to secure workers compcmntion c,;Jverage is un!uwlul ,,mt sh•ill 5t1bject an ~rnpfoye.r to
cdmlnal prena!ties t1nd dvll fines up to $10-0,000,00, in additlon the to ~ho-rnst (,f wmpmwatiun, J.imr\gos ;is provld~d for In 5£ttion 3706 of tht: l<1bor Corltt,
intcrt",t and attorneVs fees.
I hc-reby .iffirm that there is <l c011stn1n10n lentlini: ,1gen~y ior the ;wrfotm<HV ,, oi thP work th\ p1~1 rnit !~ i;\ut:d \Sec. JOT/ 11) (;vii Code).
:::;:::~OR PRINT:_J_a_m_e_s_R_, _L_o_r.cd ____ SIG::"";z~5J?; DATE: 12/3/2020
I hereby offirrn thoi I am exemptfrvm Cantrnctor's License Low for thefo!Jowing reason:
L,jt as owrwr of the property or my iimp!oyel'!s with wage\ as their sol,:,, rnmpens.;t1on, will do the work a:1d th!:' sttut:tllrn i~ nnt 1ntrndrJ or offor~rl for sal.--, (5c(
7044, BLl$iness ilnd Profession~ Code: The Conlrattor',~ Ue-en~e l,1w dol•~ not ,;1ppiy to -in own~r of property who buHd5 m improve~ thereon. ilnd who does ~w:h work
himself or through his own err,µloyeos, providNJ that ~uch improW'ffll!J1ts are not int1cndt'd m offered for ,ale. If, however, thn buildmg 01 irnpruverne11t i;; sold withir,
one year of completion, thr> owncr--buillicr wi!I hi!ve the bqrdt:n ol proving that he d!d not build 01 iinpr,wc, for the purpo5f.' of s;1ln).
[JI, ns owner of the propr,rty, :nn t>Xclll';ively cont meting With licensed contrnctors to rnn;trnc\ the projed {Sec. /044, Susine;s ond Pr,1fessions Corl<.': Tht.'
Contractor's Ln:ens1: Law does not ;ipply to an owner of properly whn l)11ifrh 01 Improves thereon, a11d rnnt1acts for such pr0)t!Cts wlth w11tr.-ictor(~) l!t:i'.!n~eJ
pursu<Jnt to !he Conltc1ctor's LlcPnse lil\v).
[] f om exen1pt under Business a:1d Professions Code Division 3, ChJµter 9, Ar;.iclr?, for this reason:
nv IT y \ig11;1!>/I{' u,,iow' .16·: ,·,·-·:k·d:;,:-ll\.-1!. •xn°;,i i·,, '"'V p1_.i·,c,1,1! ,·~·:i:dN:, ') jp "!/hi(:\ I :i",,J'l :,.;,·,' ·<-,!] k, ·,,:,:t (JC( ,,·i;,, i , <.,:f\"")1,;,;,_;I) :,f h
iinpr;iv,:m,,n\:,f,{)\'iC!'Cd l,y fr,:, p,::·•,,il, •, (',)'jj\1)\ i''r:,\ i'{ '">)I,) ;l :,,1:11,, \'!)c<'. Ir,.,,_,,, !y:-lt ,i, .1:·, 0\/ofW: h:;;1,-'v ;fit h I',-:1<)! 1)1;.:1, U 11'.'-(:,H :, ·i !t\ :f; ,' i':/' \' ,"y :;\'.('lh<.·''
t ,,11r1 .1, I,;,~-I umfl'r~nmd Um! ti copy (Jj the app!Jmhle Faw, Section 704,/ of tric Hvsim:ss and Pwfc~5iom Code, i5 availahh:: upon request wlw11 ll1i~ applirnUn11 is
.e:iihmittcd Or' nt the fo//owmg Web sitr:·: hf!p://www.fcqf11fo.w.gov/wlmv,!/tm!.
OWNER PRINT: SIGN: __________ DATE: ______ _
By my .<;ignaiure bt>low, I ce1t1fy that: I om tl1c propeuy owner or Stare of Cafifomin l.i(ensed Cootmctor or wuhoriteci to oct on the properly
owner or contractor',~ be!ialf l certify that I hov<..' n:0,1 the appficotioo and _qate thot the above information 1s corrcu arid tfmt the information 011
the plans is ocwrate. I agree to wmplv with all City ordinoncc.s ond 5tote laiv.s rc!oti11q to buildin9 r.onstruction.
I hereby authorize representative of the City of Cm/51,ad i-o enter upon the above mentioned property for inspection purposes. I AI.SOAGRFE' TO SAVE.
INDEMNIFY AND KEEP HARMLESS 1/--lt Ci1Y Of CA(flSBAD AGAINS1"ALL l /ABIWJES, JUlJGMfNlS COST~ AND EXPEN5f5 WHJCH M4Y IN ANY WAY ACC/Wt
/\Gl\fN.SfSAI[} CITY IN CONSFO.UFNCt OF !'HE GRAN! ING OF THIS PFRMI L OSHA: An OSHA pe,mit is requhed for excavations over 5'(Y deep and
demolition or construclioo of .Hructures over 3 stories in heiqht.
APPLICANT PRINT: James R Lord SIGN: 1,,."/)f; DATE: 10/16/2002 --;-,,&----1""" _,,_ ___ _
f-'h. 76-0-GOJ--l/19 Fax: 1GJ-b0Z-8S'>B
HFV .. 0H/20
Building Permit Inspection History Finaled
(city of
Carlsbad
Permit Type: BLDG-Residential Application Date: 10/28/2020 Owner: OWNER ELDRIDGE TOMMIE D AND
IRIS S
Work Class: Alteration Issue Date: 12/03/2020 Subclivision: CARLSBAD TCT#98-14-03
THOMPSON/TABATA
Status: Closed -Finaled Expiration Date: 09/22/2021 Address: 1047 SAGEBRUSH RD
CARLSBAD, CA 92011-3974
Scheduled
Date
03/25/2021
03/26/2021
09/07/2021
IVR Number:
Actual Inspection Type
Start Date
Inspection No.
03/25/2021 BLDG-14 153502-2021
Frame/Steel/Bolting/We
!ding (Decks)
Checklist Item
BLDG-Building Deficiency
COMMENTS
03/26/2021 BLDG-14 153594-2021
Frame/Steel/Bolting/We
!ding (Decks)
Checklist Item
BLDG-Building Deficiency
COMMENTS
09/07/2021 BLDG-Final Inspection
Checklist Item
165416-2021
COMMENTS
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
Tuesday, September 7, 2021
29652
Inspection Primary Inspector Reinspection Inspection
Status
Failed Paul Burnette Re inspection Incomplete
Passed
No
Passed Paul Burnette Complete
Passed
No
Passed Paul Burnette Complete
Passed
Yes
No
No
Yes
No
Page 1 of 1
✓• EsG1I
DATE: 11-30-2020
JURISDICTION: Carlsbad
PLAN CHECK#.: CBR2020-2781.RC1
PROJECT ADDRESS: 1047 Sagebrush Road
SET II
JPPLICANT
/ JURIS.
PROJECT NAME: Eldridge Residence-2 New Exterior Doors Replacing Windows
~ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D 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 EsGil
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:
~ EsGil staff did not advise the applicant that the plan check has been completed.
D EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted:l llC()Jzo (bc;m ) Email:
Mail Telephone Fax In Person
0 REMARKS:
By: Erich A. Kuchar, P.E. Enclosures:
EsGil
11-19-2020
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
DATE: 11-12-2020
JURISDICTION: Carlsbad
PLAN CHECK#.: CBR2020-2781
✓• EsG1I
SET I
PROJECT ADDRESS: 1047 Sagebrush Road
□ APPLICANT
□ JURIS.
PROJECT NAME: Eldridge Residence-2 New Exterior Doors Replacing Windows
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D 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.
[8J The check list transmitted herewith is for your information. The plans are being held at EsGil
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 EsGil staff did not advise the applicant that the plan check has been completed.
[8J EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: James Lord Telephone#: 760-803-2260
Date contacted: (by: ) Email: lordjim@prodigy.net
Mail Telephone Fax In Person
0 REMARKS:
By: Erich A. Kuchar, P.E. Enclosures:
EsGil
11-2-2020
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
Carlsbad CBR2020-2781
11-12-2020
PLAN REVIEW CORRECTION LIST
SINGLE FAMILY DWELLINGS AND DUPLEXES
PLAN CHECK#.: CBR2020-2781 JURISDICTION: Carlsbad
PROJECT ADDRESS: 1047 Sagebrush Road
FLOOR AREA:
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 10-28-2020
DATE INITIAL PLAN REVIEW
COMPLETED: 11-12-2020
FOREWORD (PLEASE READ):
STORIES: 2
HEIGHT:
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 11-2-2020
PLAN REVIEWER: Erich A. Kuchar, P.E.
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 CBR2020-2781
11-12-2020
PLANS
1. Please make all corrections, as requested in the correction list. Submit FOUR new
complete sets of plans for commercial/industrial projects (THREE sets of plans for
residential projects). For expeditious processing, corrected sets can be submitted
in one of two ways:
1. Deliver all corrected sets of plans and calculations/reports directly to the City of
Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760)
602-2700. The City will route the plans to EsGil and the Carlsbad Planning,
Engineering and Fire Departments.
2. Bring TWO corrected set of plans and calculations/reports to EsGil, 9320
Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all
remaining sets of plans and calculations/reports directly to the City of Carlsbad
Building Department for routing to their Planning, Engineering and Fire
Departments.
NOTE: Plans that are submitted directly to EsGil only will not be reviewed by the
City Planning, Engineering and Fire Departments until review by EsGil is complete.
2. A reminder that due to Covid-19, the City will not permit counter corrections.
Please make sure all the items are satisfied; otherwise, another round of
corrections will be necessary.
3. Provide a statement on the Title Sheet of the plans stating that this project shall
comply with the 2019 California Residential Code, which adopts the 2019 CBC,
2019 CMC, 2019 CPC and the 2019 CEC. Section R106.1. Sheet 1 is calling out
the wring code years.
4. Sheet 6 is required to be stamped and signed by engineer of record John Schmit,
P.E. #35417 as responsible engineer in charge matching calc packaging
provided.
5. Provide either complete title 24 sheets or at minimum new glass door cut sheet
showing complaint U values.
6. Provide architectural details for waterproofing/ finishes of new doors.
MISCELLANEOUS
7. To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Carlsbad CBR2020-2781
11-12-2020
8. Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located in the plans.
• Have changes been made to the plans not resulting from this correction list?
Please indicate:
Yes □ No □
9. The jurisdiction has contracted with EsGil, located at 9320 Chesapeake Drive,
Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to
perform the plan review for your project. If you have any questions regarding
these plan review items, please contact Erich A. Kuchar, P.E. at EsGil. Thank
you.
Carlsbad CBR2020-2781
11-12-2020
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Erich A. Kuchar, P.E.
BUILDING ADDRESS: 1047 Sagebrush Road
BUILDING OCCUPANCY: R-3
PLAN CHECK#.: CBR2020-2781
DATE: 11-12-2020
BUILDING AREA
PORTION (Sq.Ft.}
Exlerior Wall Work
203
Air Conditioring
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb
• 11997 UBC BuIld1ng Permit Fee .::J
I /".I ,,II
I 1997 UBC Plan Check Fee
I !"I .,1:
i:l
Valuation
Wliplier
24.81
By Ordinance
Type of Review: I-' Complete Review
r Repetitive Fee "Ill I .::J Repeats
r Olher
r Hourly
EsGilFee ,
Reg. VALUE
Mod.
r Structural Only
f------1] Hr. @ *
Sqft of work= (12'-8" x 8'-0") x 2 = 202.7 sqft x $24.81 = $5028.99
($}
5,029
5,029
$51.427
Sheet 1 of 1
(_ City of
Carlsbad
OWNERS
AUTHORIZED
AGENT FORM
B-62
Development Services
Building Division
1635 Faraday Avenue
760·602.z719
www.car1sbvdca gov
OWNER'S AUTHORIZED AGENT FORM
Only a property owner, contractor or tflt.~ir outhorued agent may submit p!am and opplicorions for bu1fcJiriq
permits. To authorize a rhird--party agent to sign for() building permit, the owner's third party ogeM must bring
this signed form, which identifies the 09ent and the owner who s/ftc 1s representing, ond for what jobs ~/he
may obroin pt:rmit.r;. The form must be crJmpleted in its eritirety to be accepted by the City for each separate
permit appltcotmn.
Note: The following Ownl"r'"l Authorized Agent form Is required to be completed by the
'property owner only when designating on agent to apply for a construction permit
on his/her behalf.
AUTHORl2ATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
E~ctuding the Property Owner Acknowledgement, the execution of which I understund i5 my pcrs.on;;,I rcspons1b1l1ty,
I hereby authorize the following person(s) to act as my a1;cntls) to apply for, sign, ..ind file the document:. neces~.iry
to obtain 3n Owner-Builder Permit for my project.
Scope of Cons;truction Project (or Description of Work). _2 __ n_e_w __ d_o_o_r_s ___________ _
Project Locat,on or Address 104 7 Sagebrush Rd.
Name of Authonzed Agent: _J_a_m_e_s_L_o_rd _______ Tel No. 7608032260
Mdressof Autho"'ed Agent 57 4 Hygeia Ave
Encinitas, CA 92024
1 declare under penalty of perjury that I am the property owner for the address listed abo11e and I persont'llly fili€d
out the above information and certify its <11ccuracy.
Property Owner's Signature: ~-•,_,_,."-~..,.n=e1• .. ,-,,:,,._y..,., ..,C)._...:._;::S:::::,-..::....;;::-,-;::,. ___ ~ Oatr.: _ \'tl ( 2-'-t { 7 b 22)
City of Carlsbad Climate Action Plan Consistency Checklist
Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project.
For alterations and additions to existing buildings, attach Building Permit Valuation worksheet.
Building Permit Valuation (BPV) from worksheet:$ i{-O, 0 0 0, "° ,