HomeMy WebLinkAboutMCUP 15-14; Fitness Revolution; Conditional Use Permit (CUP) (2)City of
Carlsbad
APPLICATIONS APPLIED FOR: (CHECK BOXES)
LAND USE REVIEW
APPLICATION
P-1
Development Services
Planning Pivision
1635 Faraday Avenue
(760).602-4610
www.carlsbadca.gov
Development Permits (FOR DEPT. USE ONLY) Legislative Permits {FOR DEPT. USE ONLY)
0 Coastal. Development Permit (*) 0 Minor
~ Conditional Use Permit {*)
Ill Minor 0 Extension
0 Day Care (Large)
0 Environmental Impact Assessment
0 Habitat Management Permit D Minor
0 Hillside Developmfl!nt Permit (i 0 Minor
0 Nonconforming Construction Permit
0 Planned Development Permit 0 Minor
0 Residential 0 Non-Residential
0 Planning Commission Determination
D Reasonaple Accommodation
0 Site Development Plan 0Minor
0 Special Use Permit
0 Tentative Parcel Map (Minor Subdivision)
0 Tentative Tract Map (Major Subdivision)
0 Variance 0Minor
ftAwP\?It{
I
;
..
0 General Plan Amendment
D Local Coastal Program Amendmen1t (*)
0 Master Plan
0 Specific Plan
0 Zone Change (*)
0Amendment
0Amendment
0 Zone ,Code Amendment
',
SoUth C8rl5bad Coastal Review Area Permits
0 Review Permit
0 Administrative 0 Minor 0 Major
Village Review Area Permits
0 Review Permit
0 Administrative 0 Minor 0 Major
{*) = eligible for 25% discount
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS MUST BE SUBMITTED PRIOR TO 3:30P.M. A PROPOSED PROJECT REQUIRING ONLY ONE
APPLICATION MUST BE SUBMITTED PRIOR TO 4:00P.M.
ASSESSOR PARCEL NO(S).: 209-041-04 ~~--~------~--------------~----------~----------------PROJECT NAME: Fitness Revolution
~~~~~~~~~~~~--~~~--~~~--~--~---~--~-----------
BRIEF DESCRIPTION oF PROJECT: Conditional Use Permit for a perosnal training and fitness studio
BRIEF LEGAl:DESCRIPTION: Parcel C Of Parcel Map No. 1703,Portion of Lot 8 of Rancho Agua Hedionda, Map No. 823
LOCATION OF PROJECT: 5810 El Camino Real· Suite B
STREET ADDRESS
ON THE: East SIDE OF El Camino Real
----:(:-:-NO:::-:R::-:T:::-H:-, s-=o=-=u'""'TH=-:-, EA:-:-:S:::T:-:; WE~S=T)=---(NAME OF STREET)
BElWEEN faraday Ave AND Orion Rd
(NAME OF STREEl) (NAME OF STREET)
1)1Wo\ osi
P-1 Page 1 of6 Revised 07115
APPLICANT NAME (Print): Joel Malfavon
MAILING ADDRESS: 340 $ lemon Ave #4692
CITY, STATE, ZIP: Walnut, CA 91788
TELEPHONE: 949-4{)4... 7361 --------------------------EMAIL ADDRESS: Joei@Malfavon.com
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESEI~TATIVE OF THE OWNER
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY :ZBOVE INFORMATION IS TRUE AND CORRECT TO
KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS OWLEDGE.
SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR
~:F ~~APPUC:ON. ~ fO >"/ _ ~~ 9--L8-t5 ~.. v--_,.-(.4.)/S
SIGNATURE DATE /(" ~ DATE .. ":7C: :...--,.,.:;-
APPLICANTS REPRESENTATIVE (Print): N/A ~----------------------------------------------------MAILING ADDRESS:
CITY, STATE', ZIP:
TELEPHONE:
EMAIL ADDRESS:
I CERTIFY THAT I AM THE REPRESENTATIVE OF THE APPLICANT FOR
PURPOSES OF THIS APPLICATION AND THAT ALL THE ABOVE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE.
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. IMIE CONSENT TO ENTRY FOR THiS PURPOSE.
NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING
\... . -RECORDED ON THE TITLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH
'/) THE LAND AND BIND ANY SUCCESSORS IN INTEREST. cS:dw·w ?~ ··
PlmPERTY OWNER SIGNATURE
FOR CITY USE ONLY
AUG JL 9 2015
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
P-1 Page 2 of6 Hevised 07115
PAC r~F I C COAST
I L E PA
1111 E. Katella Ave, #120
Orange, CA 92867
Title Officer: Jim Jean
Title Phone: 714-516-6700
Title Email: jjean@pct.com
Issuing Policies of Commonwealth Land Title Insurance Company
9RDER NO.: 97522054-75
JOEL MALFAVON
I
ATTN: JOEL MALFAVON
PROPERTY: 5810 EL CAMINO REAL, CARLSBAD CA
92008
Escrow/Customer Phone:
PRELIMINARY REPORT
In response to the application for a policy of title insurance referenced herein, Pacific Coast Title Company hereby reports
that it is prepared to issue, or cause to be issued, as of the date hereof, a policy or policies of title insurance describing the
land and the estate or interest therein hereinafter set forth, insuring against loss which may be sustained by reason of any
defect, lien or encumbrance not shown or referred to as an exception herein or not excluded from coverage pursuant to the
printed Schedules, Conditions a.nd Stipulations or Conditions of said policy forms.
The printed Exceptions and Exclusions from the coverage and Limitations on Covered Risks of said policy or policies are set
forth in Attachment One. The policy to be issued may contain an arbitration clause. When the Amount of Insurance is less
than that set forth in the arbitration clause, all arbitrable matters shall be arbitrated at the option of either the Company or
the Insured as the exclusive remedy of the parties. Limitations on Covered Risks applicable to the CLTA and ALTA
Homeowner's Policies of Title Insurance which establish a Deductible Amount and a Maximum Dollar Limit of Liability for
certain coverages are also set forth in Attachment One. Copies of the policy forms should be read. They are available from
the office which issued this report.
This report (and any supplements or amendments hereto) is issued solely for the purpose of facilitating the issuance of a
policy of title insurance and no liability is assumed hereby. If it is desired that liability be assumed prior to the issuance of a
policy of title insurance, a Binder or Commitment should be requested
The policy(s) of title insurance to be issued hereunder will be policy(s) of Commonwealth Land Title Insurance Company, a
Nebraska Corporation.
Please read the exceptions shown or referred to herein and the exceptions and exclusions set forth in Attachment One of
this report carefully. The exceptions and exclusions are meant to provide you with notice of matters which are not covered
under the terms of the title insurance policy and should be carefully considered.
It is impoFtant to note that this preliminary report is not a written representation as to the condition of title and may not
list all liens, defects and encumbrances affecting title to the land.
Pacific Coast Title Company
Page 1
Commonwealth Land Title Insurance
Company
Michael Gravelle
CLTA Preliminary Report Form-Modified (11-17-06)
PACIFIC COAST
I L E
PRELIMINARY REPORT
EFFECTIVE DATE: July 10, 2015, 7:30am
The form of policy or policies of title insurance contemplated by this report is:
ALTA Homeowner's Policy of Title Insurance for a One-to-Four Family Residenc:e (02/03/10)
1. THE ESTATE OR INTEREST IN THE LAND HEREINAFTER DESCRIBED OR REFERRED TO COVERED BY THIS
REPORT IS:
A FEE
2. TITLE TO SAID ESTATE OR INTEREST AT THE DATE HEREOF IS VESTED IN:
PRISCILLA P. WALDVOGEL, JANICE P. ENGELHARD, STEVEN KEITH PALMER~, RJP PARTNERS,
LLC, CAROLINE DILLON AKA CAROLINE E. BARR, KRISTA MCFADDEN, LANCIE HENlE, ROBERT
HENlE, RYAN H. BARR AND CAROLINE E. BARR, TRUSTEES OF THE BARR FAMILY TRUST DATED
APRIL 13, 2011, BHM PARTNERS, LLC, A CALIFORNIA LIMITED LIABILITY CC»MPANY, EACH AS
THEIR RESPECTIVE INTERESTS APPEAR OF RECORD
3. THE !!AND REFERRED TO IN THIS REPORT IS DESCRIBED AS FOLLOWS:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF
Page 2 CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT
LEGAL DESCRIPTION
EXHIBIT"A"
Pacific Coast Title Company
ORDER NO.: 97522054-75
THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE COUNTY OF SAN DIEGO, STATE OF
CALIFORNIA, AND IS DESCRIBED AS FOLLOWS:
PARCEL C OF PARCEL MAP NO. 1703, FILED IN THE OFFICE OF THE COUNTY RECORDER OF SAN DIEGO
COUNTY, CALIFORNIA, JULY 6, 1973, BEING A PORTION OF LOT B OF RANCHO AGUA HEDIONDA, IN THE
COUNTY OF SAN DIEGO, STATE OF CALIFORNIA, ACCORDING TO MAP THEREOF NO. 823, FILED IN THE
OFFICE OF THE COUNTY RECORDER, NOVEMBER 16, 1896.
Page 3 CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT Pacific Coast Title Company
ORDER NO.: 97522054-75
AT THE DATE HEREOF, ITEMS TO BE CONSIDERED AND EXCEPTIONS TO COVERAGE IN ADDITION
TO THE PRINTED EXCEPTIONS AND EXCLUSIONS IN SAID POLICY FORM WOULD BE AS FOLLOWS:
A Property Taxes, which are a lien not yet due and payable, including any assessments collected with
taxes to be levied for the fiscal year 2015-2016.
B. Property Taxes, including any personal property taxes and any assessments collected with taxes, for
the fiscal year 2014-2015 Assessor's Parcel Number 209-041-04-00.
Code Area:
1st Installment:
2nd Installment:
Land:
Improvements:
Exemption:
09013
$6,297.80 PAID
$6,297.80 PAID
$476,796.00
$667,690.00
$0.00 HOMEOWNERS
C. The lien of supplemental taxes, if any, assessed pursuant to the prov1s1ons of Chapter 3.5
(Commencing with Section 75) of the Revenue and Taxation Code of the State of California.
1. Water rights, claims or title to water, whether or not disclosed by the Public Records.
2. Easement(s) for the purpose(s) shown below and rights incidental thereto as granted in a document;
Granted to:
Purpose:
Recorded:
Affects:
LILLIE KELLY ORTEGA, ET AL
ROADWAY, POLE LINE AND PIPE LINES
July 29, 1936 IN BOOK 541 PAGE 244 OF OFFICIAL RECORDS
AS SHOWN IN SAID DOCUMENT
The exact location and extent of said easement is not disclosed of record.
3. THE FACT THAT THE RIGHT TO EXCAVATE AND TO EXTEND DRAINAGE STRUCTURES AND
EMBANKMENT SLOPES BEYOND THE LIMITS OF THE STREET OR HIGHWAY NAMED BELOW, WHERE
REQUIRED FOR THE CONSTRUCTION AND MAINTENANCE THEREOF, HAS BEEN GRANTED IN A
DOCUMENT;
STREET/HIGHWAY: ROAD SURVEY 682 (EL CAMINO REAL)
GRANTED TO: THE COUNTY OF SAN DIEGO
RECORDED: AUGUST 21, 1940 IN BOOK 1054 PAGE 360, OF OFFICIAL RECORDS
REFERENCE IS MADE TO SAID DOCUMENT FOR FULL PARTICULARS.
4. THE FACT THAT THE RIGHT TO EXCAVATE AND TO EXTEND DRAINAGE STRUCTURES AND
EMBANKMENT SLOPES BEYOND THE LIMITS OF THE STREET OR HIGHWAY NAMED BELOW, WHERE
REQUIRED FOR THE CONSTRUCTION AND MAINTENANCE THEREOF, HAS BEEN GRANTED IN A
DOCUMENT;
STREET/HIGHWAY: ROAD SURVEY 692 (EL CAMINO REAL)
GRANTED TO: THE COUNTY OF SAN DIEGO
RECORDED: OCTOBER 2, 1940, IN BOOK 1075 PAGE 403, OF OFFICIAL RECORDS
REFERENCE IS MADE TO SAID DOCUMENT FOR FULL PARTICULARS.
5. ANY DISCREPANCIES IN BOUNDARY OR ANY RIGHTS WHICH MAY ARISE OR EXIST WHICH ARE
DISCLOSED BY
Page 4
.
RECORD OF SURVEY NO.: 5683
RECORDED: DECEMBER 1, 1960 INSTRUMENT/FILE NO. 234636, OF OFFICIAL RECORDS
AFFECTS: VARIOUS BOUNDARIES AND DIMENSIONS OF SAID LAND
CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT Pacific Coast Title Company
ORDER NO.: 97522054-75
6. THE FACT THAT THE RIGHT TO EXCAVATE AND TO EXTEND DRAINAGE STRUCTURES AND
EMBANKMENT SLOPES BEYOND THE LIMITS OF THE STREET OR HIGHWAY NAMED BELOW, WHERE
REQUIRED FOR THE CONSTRUCTION AND MAINTENANCE THEREOF, HAS BEEN GRANTED IN A
DOCUMENT;
STREET/HIGHWAY: ROAD SURVEY 1800 (EL CAMINO REAL)
GRANTED TO: THE COUNTY OF SAN DIEGO
R,ECORDED: NOVEMBER 5, 1969 INSTRUMENT/FILE NO. 203562, OF OFFICIAL RECORDS
REFERENCE IS MADE TO SAID DOCUMENT FOR FULL PARTICULARS.
7. The fact that the ownership of said land does not include rights of access to or from the street, highway
or freeway abutting said land, such rights having been relinquished by the document,
Recorded:
Affects:
And Re-Recorded:
July 06, 1973 AS INSTRUMENT NO. 73-186934 OF OFFICIAL RECORDS
A PORTION OF THE NORTHEASTERLY RIGHT-OF-WAY LINE OF EL
CAMINO REAL ADJACENT TO SAID LAND
September 13, 1973 AS INSTRUMENT NO. 73-2S8164 OF OFFICIAL
RECORDS.
8. A document entitled AGREEMENT BETWEEN OWNER, DEVELOPER AND THE CITY OF CARLSBAD FOR
THE PAYMENT OF A PUBLIC FACILITIES FEE, dated 08/22/1983, executed by NORTH COUNTY BANCORP
AND CALIFORNIA FIRST BANK, A CALIFORNIA BANKING CORPORATION, AS TRUSTEE, subject to all the
terms, provisions and conditions therein contained, recorded December 27, 1983 AS INSTRUMENT NO.
83-470806 OF OFFICIAL RECORDS.
Reference is hereby made to said document for full particulars.
9. A document entitled AGREEMENT BETWEEN OWNER, DEVELOPER AND THE CITY OF CARLSBAD FOR
THE PAYMENT OF A PUBLIC FACILmES FEE, dated 09/26/1986, executed by FEDERAL EXPRESS
CORPORATION AND EL CAMINO REAL PARTNERSHIP, subject to all the terms, provisions and conditions
therein contained, recorded October 24, 1986 AS INSTRUMENT NO. 86-483002 OF OFFICIAL RECORDS.
Reference is hereby made to said document for full particulars.
10. A document entitled HOLD HARMLESS AGREEMENT DRAINAGE, dated 10/28/1987, executed by EL
CAMINO REAL PARTNERS AND THE CITY OF CARLSBAD, subject to all the terms, provisions and
conditions therein contained, recorded November 03, 1987 AS INSTRUMENT NO. 87-618559 OF
OFFICIAL RECORDS.
Reference is hereby made to said document for full particulars.
11. ANY RIGHTS OF THE PARTIES IN POSSESSION OF A PORTION OF, OR ALL OF, SAID LAND, WHICH
RIGHTS ARE SET FORTH IN UNRECORDED LEASES, WITH CERTAIN TERMS, COVENANTS, CONDmONS
AND PROVISIONS SET FORTH THEREIN AS DISCLOSED BY VARIOUS DOCUMENTS OF RECORD.
12. A' NOTICE OF RESTRICTION ON REAL PROPERTY
RECORDED: SEPTEMBER 12, 1995 AS INSTRUMENT NO. 1995-0406401, OF OFFICIAL RECORDS
REFERENCE IS MADE TO SAID DOCUMENT FOR FULL PARTICULARS.
13. A document entitled JOINT USE PARKING AGREEMENT, dated 10/17/1995, executed by EL CAMINO
REAL PARTNERS AND ABUNDANT LIFE CHRISTIAN CENTER, subject to all the terms, provisions and
conditions therein contained, recorded December 12, 1995 AS INSTRUMENT NO. 1995-0564098 OF
OFFICIAL RECORDS.
Reference is hereby made to said document for full particulars.
Page 5 CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT Pacific Coast Title Company
ORDER NO.: 97522054-75
14. A Deed:
Grantor:
Grantee:
Dated:
Recorded:
SUZANNE P. DILLON, AN UNMARRIED WOMAN, AS HER SOLE AND
SEPARATE PROPERTY
STEVEN K. PALMER, A 4.166% INTEREST, PRISCILLA P. WALDVOGEL, A
4.166% INTEREST AND JANICE P. ENGELHARD, 4.166% INTEREST, AS
TENANTS IN COMMON IN
November 22, 1994 AS INSTRUMENT NO. 1994-0675915 OF OFFICIAL
RECORDS
For insurance purposes, the Company is not willing to divest the interest of the above stated Grantor. An
inquiry of the parties shall be required.
Note: In order to complete this report, this company requires a signed and notarized Affidavit from the
above stated Grantor. The blank Affidavit form is attached to this report for your convenience .
.
15. An unrecorded lease with certain terms, covenants, conditions and provisions set forth therein as
disclosed by a document
Entitled:
Lessor:
Lessee:
Recorded:
NOTICE NON-RESPONSIBILITY
THE SOUTHWEST COMMUNITY BANK
EL CAMINO REAL PARTNERS
December 20, 2000 AS INSTRUMENT NO. 2000-0692917 OF OFFICIAL
RECORDS
16. Easement(s) for the purpose(s) shown below and rights incidental thereto as granted in a document;
Granted to:
Purpose:
Recorded:
Affects:
CITY OF CARLSBAD, A MUNICIPAL CORPORATION
PUBLIC UTILITY
March 06, 2007 AS INSTRUMENT NO. 2007-01S3038 OF OFFICIAL
RECORDS
THAT PORTION OF SAID LAND AS SHOWN THEREIN
17. We find no open Deeds of Trust of record. Please verify by inquiry of escrow personnel and/or agents
whether or not we have overlooked something and advise the title department accordingly prior to close
of escrow.
18. A court order for installment payments of spousal and/or child support, to be made by:
Debtor:
Creditor:
County:
Court:
Case No.:
Recorded:
ROBERT HENIE JR.
COUNTY OF SAN DIEGO
SAN DIEGO
SUPERIOR
DF202851
April 23, 2008 AS INSTRUMENT NO. 2008-0215978 OF OFFICIAL
RECORDS
19. An abstract of judgment for the amount shown below and any other amounts due:
Amount:
Debtor:
Creditor:
Date Entered:
County:
Court:
Case No.:
Recorded:
Page 6
$6,772.36
ROBERT HENIE, AN INDIVIDUAL AKA ROBERT HENIE, JR. AKA ROB
HENlE
SAN FRANCISCO EQUINE, INC.
05/08/2009
SAN DIEGO
SUPERIOR
37-2008-00104296-CL -C
September 16, 2009 AS INSTRUMENT NO. 2009-0517147 OF OFFICIAL
RECORDS
CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT Pacific Coast Title Company
ORDER NO.: 97522054-75
20. We find various Liens and Judgments, that are of record against persons with similar or the same
name as that of our vestee(s) shown herein. In order to complete this report, this Company requires a
Statement of Informa·tion to be provided for the following vestee(s), which may allow and assist
elimination of some or all of said Liens and Judgments. After review of the requested Statement(s) of
Information, the Company reserves the right to add additional items or make further requirements prior
to the issuance of any Policy of Title Insurance.
v;stee(s): VESTEES HEREIN
21. This Company will require that the spouse (if any) of the vestee named below join in any conveyance
or encumbrance before such transaction will be insured.
Vestee(s): VESTEES HEREIN
22. Before issuing its policy of title insurance, this Company will require for n:!view, the following
documents from the Limited Liability Company named below.
Limited Liability Company:
(a)
(b)
(c)
(d)
(e)
RJP PARTNERS, LLC AND BHM PARTNERS, LLC, A CALIFORNIA LIMITED
LIABILITY COMPANY
A copy of its operating agreement and any and all amendments,
supplements and/or modifications thereto, certified by the appropriate
manager or member.
Confirmation that its Articles or Organization (LLC-1), and Certificate of
Amendment (LLC-2), any restated Articles of Organization(LLC-10)
and/or Certificate of Correction (LLC-11) have been filed with the
Secretary of State.
If the Limited Liability Company is member-managed a full and complete
current list of members certified by the appropriate manager or member.
If the Limited Liability Company was formed in a foreign jurisdiction,
evidence, satisfactory to the Company, that it was validly formed, is in
good standing and authorized to do business in the state of origin.
If the Limited Liability Company was formed in a foreign jurisdiction,
evidence, satisfactory to the Company, that it has completed with
California "doing business" laws, if applicable.
After review of the requested documents, the Company reserves the rights to add additional items or
make additional requirements prior to the issuance of any policy of title insurance.
23. This Company will req1L1ire that a full copy of any unrecorded lease referred to herein be furnished to
this Company, together with all supplements, assignments and amendments for review. The right is
reserved to make additional requirements or to add additional items after review of the requested
documentation.
24. Any rights of the parties in possession of a portion of, or all of, said land, which rights are not
disclosed by the public record.
25. The Company will require that the attached "Owner's Information StatemEmt" be completed
by the owner of the estate described or referred to in herein immediately prior to the close of this
transaction and returned to us.
Page 7
The purpose of the Owner's Information Statement is to provide the Company with certain information
that cannot necessarily be ascertained by making a physical inspection of the Land.
CLTA Preliminary Report Form-Modified (11-17-06)
PRELIMINARY REPORT Pacific Coast Title Company
ORDER NO.: 97522054-75
26. Covenants, conditions and restrictions and other instruments recorded in the public records
purporting to impose a transfer fee or conveyance fee payable upon the conveyance of an interest
in real property or payable for the right to make or accept such a transfer, and any and all fees, liens or
charges, whether recorded or unrecorded, if any, currently due or payable or that will become due or
payable, and any other rights deriving therefrom, that are assessed pursuant thereto.
END OF ITEMS
Page 8 CLTA Preliminary Report Form-Modified (11-17-06)
Gityof
Carlsbad
DISCLOSURE STATEMENT
P-1(A)
Development Services
Planning Division
1635 Faraday Avenue
(760) 602-4610 .
www.carlsbadca.gov .
Applicant's statement or disdosure of certain ownership int.erests on all applications which will
require discretionary action on the part of the 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.
1. APPLICANT (Not the appli~nt's agent)
Provide the COMPLETE. LEGAL names and addresses of & persons having a
financial interest in the application. If the applicant includes a corporation or partnership,
include the names, titles, addresses of all individuals owning more than 1 0% 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 Q!Jblicly-owned
corporation, include the names, titles, and addresses of the corporate officers. (A
separate page may be attached if necessary.)
PersonJoel Malfavon corp/PartmVerticals LLC
Title Managing Member: Title ·----------------------------------------------
Address'-----------------------------Address340 S Lemon Ave Walnut CA, 91788
2. OWNER (Not the owner's agent)
P-t(A)
Provide the COMPLETE. LEGAL names and addresses of ALL persom> 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 tJ:lan 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 publicly-owned corporation, include the names, titles, and
addresses of the corporate officers. (A separate page may be attached if nE~cessary.)
PersonN/A '--------------~----Title. ________________ ~
Address. __________ _
Page 1 of2 Revised 07/10
3. NON-PROFIT ORGANIZATION OR TRUST
If ~ny person identified purs~.:~ant to (1) or (2) above is a nonprofit organization or a trust,
list the names and addresses of Am: person serving as an officer or director of the non-
profit organization or as trustee or beneficiary of the.
Non Profit/Trust:..-..------~
Title·-----------
Address. _________ _
Non Profit/Trust'------·----
Title _____________ _
Address. ___________ _
4. Have you had more than $500 worth of business transacted with any mE~mber of City
staff, Boards, Commissions; Committees and/or Council within the past twelve {12)
months?
DYes It~ I No If yes, ple~se indicate Prrson(s); ______ . ___ _
NOTE: Attach additional sheets if n~cessary.
:.;:
I certify that all the above information is true and correct to the best o my knowledg1e.
~4h LL-P~ ~~lq -,s
Signature of owner/date
S±-even K.?a.Loou: -·
Print or type name of owner
Signature of owner/applicant's agent if applicable/date
Print or type name of owner/applicant's agent
P-1(A) Page2 of2 Revised 07/10
Ccicyof
Carlsbad
HAZARDOUS WASTE
AND SUBSTANCES
STATEMENT
P-1(C)
Development Services
Planning Division ··
1635 Faraday Avenue
(760) 602-4610
www.c:arlsbadca.gov
Consultation of Lists of Sites Related to Hazardous Wastes
(Certification of Compliance with Government Code Section 65962.5)
Pursuant to State of California Government Code Section 65962.5, I have consulted the
Hazardous Waste and Substances Sites List compiled by the California Environmental
Protection Agency and hereby certify that (check one): I
ljJ The development project and any alternatives proposed in this application are not C<Jntained on the
lists compiled pursuant to Section 65962.5 of the State Government Code.
0 The development project and any ,alternatives proposed in this application are contained on the lists
compiled pursuant to Section 65962.5 of the State Government Code.
APPLICANT
Name:Joel Malfavon, Fitness Revolution
Addr~ss: 340 S Lemon Ave #4692
Walnut, CA 91788
Phone Number: 949-464-7:361
PROPERTY OWNER
Name: StQ\ zg_?o..\ "t'\4£
Address: 230"\ ~~~ ~rc~\ ~
~Y\o..cc..os CA q2..o1-~ I
Phone Number{ 7100 ).s 8 3 ·· 0 R 61=
Address ofSite:5810 El Camino Real Suite B, Carlsbad, CA 92008
local Agency (City and County): City of Carlsbad, San Diego County
Assessor's book, page, and parcel number:_2_0_9_-_0_4_1_-0_4 _____ ___,.. ____ , ____ _
Specifylist(s):_N_I_A __________________________ _
Regulatory ldentificatron Numbler:_N_I_A ____________________ _
Date of List: N/ A '~------·-----------~--------·-------
i8(l8/tf •
The Hazardous Waste and Substances Sites List (Cortese List) is used by thE~ State, local
agencies and developers to comply .with the California Environmental Quality Act requirements
in providing information about the lo~tion of hazardous mateFials release sites.
P-1(C) Page 1 of2 Hevised 02/13
City of
Carlsb
TIME LIMITS ON
DISCRETIONARY
PROJECTS
P-1 (E)
PLEASE NOTE:
Develot)ment Services
Planning Division
1635 Faraday Avenue
(760} 602-4610
www.carlsbadca.gov ··
Time limits on the processing of discretionary projects established by state law do not start until a
project application is deemed complete by the City. The City has 30 calendar days from the date of
application submittal to determine whether an application is complete or incomplete. Within 30 days of
submittal of this application you will receive a letter stating whether this application is complete or
incomplete. If it is incomplete, the letter will state what is needed to make this application complete.
When the application is complete, the processing period will start upon the date of the completion letter.
If you have any questions regarding application submittal requirements (i.e., clarification
regarding a specific requirement or wh her all requirements are necessary fc,r your particular
application) please call (760) 602-4610.
Applicant Signature:
Staff Signature:
Date: 'l,.-1'1-Zolf
To be stapled with receipt to the application
P-1(E) Page 1 of 1 Revised 07/10
{'city of
Carlsbad
PROJECT DESCRIPTION
P-1(8)
Development Services ·
Planning Division ·
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca~gov
PROJECT NAME: Fitness Revolution -Conditional Use Permit -Minor
APPLicANT NAME: Joel Ma:lfavon
Please describe fully the proposed project by application type. Include any detaih) necessary to
adeq\Jately explain the scope and/or operation of the proposed project. You may also include
any background information and " supporting statements regarding the reasons for, or
appropriateness of, the application. Use an addendum sheet if necessary.
Description/Explanation:
P-1(8) Page 1 of 1 Revised 07110
STORM WATER
STANDARDS
QUESTIONNAIRE
E-34
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
To address post-development pollutants that may be generated from development projects, the City requires that new development and
significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practiices (BMP's) into the project
design per the City's Standard Urban Stormwater Management Plan (SUSMP). To view the SUSMP, refer to the Engineering Standards
(Volume 4, Chapter 2).
Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision,
discretionary permits and/or construction permits). The results of the questionnaire determine the level of storm watP.r standards that
must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to
'Standard Stormwater Requirements' or be subject to additional criteria called 'Priority Development Project Requirements'. Many
aspects of project site design are dependent upon the storm water standards applied to a project.
Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has
responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire
was incorrectly filled out and is subject to more stringent storm water standards than initially assessed by you, this will result in the return
of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City.
If you are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, please
seek assistance from Land Development Engineering staff.
A separate completed and signed questionnaire must be submitted for each new development application submission. Only one
completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently.
In addition to this questionnaire, you must also complete, sign and submit a Project Threat Assessment Form with construction permits
for the project.
Please start by completing Step 1 and follow the instructions. When completed, sign the form at the end and submit this with your
application to the city.
To determine if your project is a priority development project, please answer the following questions:
1. Is your project LIMITED TO constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet
the following criteria: (1) Designed and constructed to direct storm water runoff to adjacent vegetated areas, or
other non-erodible permeable areas; OR (2) designed and constructed to be hydraulically disconnected from
paved streets or roads; OR (3) designed and constructed with permeable pavements or surfaces in
ance?
2. Is your project LIMITED TO retrofitting or redeveloping existing paved alleys, streets, or roads that a1re
designed and constructed in accordance with the USEPA Green Streets guidance?
YES NO
If you answered "yes" to one or more of the above questions, then your project is NOT a priority development project and therefore is
NOT subject to the storm water criteria required for priority development projects. Go to step 4, mark the last box stating "my
project does not meet PDP requirements" and complete applicant information.
answered "no" to both 2.
E-34 Page 1 of 3 Effective 6/27113
STORM WATER
STANDARDS
QUESTIONNAIRE
E-34
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
o determine if your project is a priority development project, please answer the following questions:
1. Is your project a new development that creates 10,000 square feet or more of impervious surfaces collectively
over the, entire project site? This includes commercial, industrial, residential, mixed-use, and public
on
2. Is your project creating or replacing 5,000 square feet or more of impervious surface collectively over the entire
project site on an existing site of 10,000 square feet or more of impervious surface? This includes commercial,
and on land.
3. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a restaurant? A restaurant is a facility that sells prepared
foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared
foods and drinks for immediate
4. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a hillside development project? A hillside development
project includes development on any natural slope that is twenty-five percent or greater.
5. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a parking lot. A parking lot is a land area or facility for the
of motor business
6. Is your project a new or redevelopment project that creates 5,000 square feet or more of imperviow;; surface
collectively over the entire project site and supports a street, road, highway freeway or driveway? A street,
road, highway, freeway or driveway is any paved impervious surface used for the transpottation of
mntnn~v,..t"'~ and other vehicles.
7. Is your project a new or redevelopment project that creates or replaces 2,500 square feet or more of
impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive
Area (ESA)? "Discharging Directly to" includes flow that is conveyed overland a distance of 200 fe~~t or less
from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the
to the ESA not with flows from *
8. Is your project a new development that supports an automotive repair shop? An automotive repair shop is a
facility that is categorized in any one of the following Standard Industrial Classification (SIC) codE~s: 5013,
5541 or
9. Is your project a new development that supports a retail gasoline outlet (RGO)? This category includE!S RGO's
that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily Traffic (ADT) of
100 or
1 O.ls your project a new or redevelopment project that results in the disturbance of one or more acres of land and
are expected to generate pollutants post construction?
2,500 square feet or more of
than 10%?
"'"~:wF>,rF>rl "yes" to one or more of the above questions, you ARE a priority development project and are therefore subject to
umnl<>m<>ntor'n structural Best Management Practices (BMP's) in addition to implementing Standard Storm Water Requirements such
source control and low impact development BMP's. A Storm Water Management Plan (SWMP) must be submitted with your
pplication(s) for development. Go to step 3 for redevelopment projects. For new projects, go to step 4 at the end of this
, ......... ,nnnai~~e, check the "my project meets PDP requirements" box and complete applicant information.
If you answered "no" to all of the above questions, you ARE NOT a priority development project and are therefore subject to
limnl<>m<>ntir'n only Standard Storm Water Requirements such as source control and low impact development BMP's required for all
opment projects. A Storm Water Management Plan (SWMP) is not required with your application(s) for development. Go to
at the end of this questionnaire, check the "my project does not meet PDP requirements" box and complete aoow~ar1t1
E-34 Page 2 of3 Effective 6/27113
STORM WATER ~""'" . Development Services
(.Jl tV STANDARDS Land oev~op1ment Engineering
~~~--~_i_s_~_IJ_.~(l_"_.(J_· __________ Q_U_E_S_T_~_~_3:_N __ A_IR __ E ____________ l_l5_3_s_Fa_~_~_~:_;_~;_~~----~ L www.carlsbadca.gov
Does the redevelopment project
50% of the surface area of the
If you answered "yes," the structural BMP's required for Priority Development Projects apply only to the creation or replacement
impervious surface and not the entire development. Go to step 4, check the "my project meets PDP requirements" box and
complete applicant information.
If you answered "no," the structural BMP's required for Priority Development Projects apply to the entire development. Go to step 4,
check the meets PDP irements" box icant information.
D My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater
criteria per the SUSMP and I understand I must prepare a Storm Water Management Plan for submittal at time of application.
I understand flow control (hydromodification) requirements may apply to my project. Refer to SUSMP for details.
My project does not meet PDP requirements and must only comply with STANDARD STORMW)I~TER REQUIREMENTS per
the SUSMP. As part of these requirements, I will incorporate low impact development strategies throughout my project.
Applicant Information and Signature Box
Addressj'{o s I~Mo,..J e 11'1{,1t
Applicant Name: W4"/ ~ /;' C4 <]/7 88
Accessor's Parcel Number(s): z (.) '1-0'1 / ... O '1
Applicant Title:
t)WAI-r/l...
Applicant Signature: H /-} LFJ(J Vorl Date:
This Box for City Use Only
City Concurrence: NO
By:
Date:
Project ID:
*Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas
designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water !Quality Control Plan for the
San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources
Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their
quivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent
environmentally sensitive areas which have been identified by the Copermittees.
E-34 Page 3 of3 Effective 6/27113
City of Ca~1sbad
Faraday Center
Faraday Cashiering 001
1523101-2 08/19/2015 156
Wed, Aug 19, 2015 03:22 PM
Receipt Ref Nbr: R1523101-2/0030
PERMITS -PERMITS
Tran Ref Nbr: 152310102 0030 0033
Trans/Rcpt#: R0111044
SET #: MCUP1514
Amount:
Item Subtota 1:
Item Tot a 1:
ITEf~(S) TOTAL:
Check (Chk# 000992)
Total Received:
Have a nice day!
1 @ $765.70
$765.70
$765.70
$765.70
$765.70
$765.70
**************CUSTOMER COPY*************
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City of Carlsbad
1635 Faraday Avenue Carlsbad CA 92008
lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll
Applicant: MALFAVON JOEL
Description Amount
MCUP1514 765.70
5810 EL CAMINO REAL CBAD
Receipt Number: R0111044 Transaction ID: R0111044
Transaction Date: 08/19/2015
Pay Type Method Description Amount
Payment Check 765.70
Transaction Amount: 765.70