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Home My WebLink AboutRP 2017-0005; PARADISE CARLSBAD A-FRAME SIGN; Review Permit (RP){city of Carlsbad LAND USE REVIEW APPLICATION P-1 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Development Permits {FOR DEPT. USE ONLY) Legislative Permits {FOR DEPT. USE ONLY) D Coastal Development Permit D Minor D Conditional Use Permit D Minor D Extension D Day Care (Large) D Environmental Impact Assessment D Habitat Management Permit D Hillside Development Permit D Minor D Minor D Nonconforming Construction Permit D Planned Development Permit D Minor D Residential D Non-Residential D Planning Commission oetennination D Reasonable Accommodation D Site Development Plan D Special Use Permit D Minor D Tentative Parcel Map (Minor Subdivision) D Tentative Tract Map (Major Subdivision) D Variance 0Minor 0 General Plan Amendment D Local Coastal Program Amendment D Master Plan D Specific Plan D Zone Change •Amendment •Amendment D Zone Code Amendment South Carlsbad Coastal Review Area Permits ~Review Permit "'&,Administrative D Minor D Major Village Review Area Permits D Review Permit D Administrative D Minor D Major f..1 1,011~ B NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION MUST BE SUBMITTED PRIOR TO 4:00 P.M. ASSESSOR PARCEL NO(S).:a 1i L I ~y PROJECT NAME~ ~ti..-~y'l(. ~c7- BRIEF DESCRIPTION OF PROJECT: ~ ~ A!..-H=..--16,._M_€_ ____ ':::._I/~----------- PROJECT VALUE (SITE IMPROVEMENTS) ESTIMATED COMPLETION DATE LOCATION OF PROJECT: 3D~ \ ~°'-cl i 50/\ 'S \ . Cc.1 \ s bc....d C, JC\ °t1..C>QI\ STREET ADDRESS ON THE: SIDE OF (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) BETWEEN Cct:IS½c....c vi\\c.~<-J.r (NAME OF STR ) AND C>c,..'l ':. \-- (NAME OF STREET) P-1 Page 1 of 6 Revised 09/16 --- ' I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR p1r:;r:r2lA:P~TION~ ~--. 1/-s--cJ SIGNATURE ~ d DATE APPLICANT'S REPRESENTATIVE (Print): 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 . . , APPLICANT NAME (Print): µ1 MC l\ :I...-c,, c,e ~AILING ADDRESS 1o"§I lt\c,d, $cc-S+ ) c1TY, sTATE, z1P, c cti,-1o.,,c c A 9 ~ sr TELEPHONE :f ( l{ ?, (.. ? '-f ? 2.S: EMAIL ADDRESS: c.o..r ,-..c:." €, ~c...c,4; s<-8 f"C:.• vi• (d,,.,._ 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 KNOWLE E. lr1i,,)1 .• -::---le&-->-. L/--7 ~ ,1 I J 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. I/WE 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 BIN NY S CCESSORS IN INTEREST. FOR CITY USE ONLY P-1 Page 2 of6 RECEIVED APR 1 7 2017 CITY O~-C/\HLSBAD DATE STAiiilh-fu&#b~1etlJ~§:lfei~ED RECEIVED BY: Revised 09/16 I ("city of Carlsbad ' " PROJECT DESCRIPTION P-1{B) - Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov PROJECT NAME: _·¥\.--=.._fv::-'-=,,,...,_M;..;.,,,C.~---------------- APPLICANT NAME: Co..,~ e" 'Tco,,c ~ '1 Please describe fully the proposed project by application type. Include any details necessary to adequately 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: 1\-frc...""'~ fur u,.rlS~ci 'ovs:"i:: S'> P-1(B) Page 1 of 1 Revised 07/10 (cityof Carlsbad HAZARDOUS WASTE AND SUBSTANCES STATEMENT P-1(C) • Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.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): D The development project and any alternatives proposed in this application are not contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. D The development project and any alternatives proposed in this application J!!!l contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. APPLICANT Name: _______________ _ Address.: _______________ _ Phone Number: ____________ _ PROPERTY OWNER Name: 11 i c h.::.e \ 6-c/Jskv Address )fa 2(s-'be,V1C<,d{ ~ks"tt- -'s,,j)\,-,~, ( Y7 ~ J;) ~ Phone Number: 9 g-~ 7 2. 2 -'( 0 ? L/ Address of Site: _____________________________ _ Local Agency (City and County): _______________________ _ Assessor's book, page, and parcel number: ____________________ _ Specify list(s): ____________________________ _ Regulatory Identification Number: _______________________ _ f List: ______ :::------------------------- 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 location of hazardous materials release sites. P-1 (C) Page 1 of2 Revised 02/13 ,....--, I ACORD• CERTIFICATE OF LIABILITY INSURANCE DATE jMMIOOIVYYY) \,,,,....-' 04/0112017 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Bennett Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2725 Jefferson St #2C HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Carlsbad, CA 92008 INSURERS AFFORDING COVERAGE NAIC# ~------------~-~------------- INSURED INSURER A CNA ------------ Carmen Tracey & Kayma Engfud: DBA: Paradise Carlsbad INSURERS 3061 Madison St Suite ~ l~~URERC _ ------Carlsbad, CA 92008 INSURER D. --- INSURER E i COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HA.VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDlTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHO\l\'N MAY HAVE SEEN REDUCED BY PAID CLAIMS. ----------··· 1~-t:IWs~r-· TYPE OF INSURANCE POLICY NUMBER____ ~~~::"~~ ~w.r..i~N UMITII : GENERAL LIABILITY 04,01/2017 ! 04(01/'"'018 eo2141saeo I • E,G.CH OCCURRENCE ' __ 2,_!)_~~ A X I COMMERCIAL GENERAL LIABILITY =-0 CLAIMS MADE [] OCCUR ' '---i-- -~ --------- GEN"L AGGREGATE LIMIT APf>LlES PER· x1 POLICY -n r~ 1 -1 LOC I AUTOMOBILE LIABILITY ,, -~~=~~:~~: HlREOAUTOS NON-ONNEO AUTOS -------------·--·-- I ' GARAGE UABfLITY ;~ ANY AUTO EXCESS/UMBRELLA UABUTY =.-J OCCUR LJ CLAIMS MADE I'~ DEOUCTIBI..E '1 RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PRCNJSIONS below ! OTHER I I i I ! ' ~~~J?e~~~~nce) ' 300,000 MED EXP (Any one person) ' 10,000 I-~~-& AOV INJURY $ 2,000,000 -------- GENERAL AGGREGATE ' 4,000,000 ~- PRODUCTS-COMPiOP AGG • 4,000,000 -• COM6!NEO SINGLE LIMI r S (Ell IICC!dflnt) ----f,- BQDIL Y INJURY S (Per person) , BODILY INJURY (Per acclollnt) ii PROPERTY DAMAGE {Per accident) • ' ' L AUTO ONLY -EA A0c=a~D=E=NT~C-'------• - OfHER THAN AUTO ONLY: EA ACC AOO EACH OCCURRENCE AGGREGATE • $ ' ---------/ -----+''-------4 ~-~~--------~i-!-.. ------• EL EACHACCIDENT S ------ E.L DlSEASf:-EA EMPLOYEE S EL DISEASE-POUCY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPED AL PR0Vl8IONS Paradise Carlsbad, A Holistic Practitioner Office, located at 3081 Madison St Suite A, Carlsbad, CA 92008 CERTIFICATE HOLDER City of Carlsbad Land Development Engineering 1635 Faraday Avenue Carlsbad, CA 92008 ' A CORO 26 (2001/08) CANCELLATION SHOULD AtlVOF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER 'MLL ENDEAVOR 1'0 IIIML ~ DAYS WRITll:N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LlABIUTYOF AtlY ,<IND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVE.II - 10 ACORD CORPORA 110N 1918 ,,. ... IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or. negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 26 (2001/08) -, ' . , Indemnification and Insurance Requirement for Village Area Administrative Permit Certification Statement I Certify that I am the Legal Business Owner of the subject business and that all of the above information is true and correct to the best of my knowledge. I agree to accept and abide by any conditions placed on the subject project as a result of approval of this application. I agree to indemnify, hold harmless, and defend the City of Carlsbad and its officers and employees from all claims, damage or liability to persons or property arising from or caused directly or indirectly by the installation or placement of the subject property on the public sidewalk and/or the operation of the subject business on the public sidewalk pursuant to this permit unless the damage or liability was caused by the sole active negligence of the City of Carlsbad or its officers or employees. I have submitted a Certificate of Insurance to the City of Carlsbad in the amount of one million dollars issued by a company which has a rating in the latest "Best's Rating Guide" of "A-" or better and a financial size of $50-$100 (currently class VII) or better which lists the City of Carlsbad as "additional insured" and provides primary coverage to the City. I also agree to notify the City of Carlsbad thirty days prior to any cancellation or expiration of the policy. The notice shall be delivered to: City Planner City of Carlsbad 1635 Faraday Avenue Carlsbad The insurance shall remain in effect for as long as the property is placed on the public sidewalk or the business is operated on the public sidewalk. This agreement is a condition of the issuance of this administrative permit for the subject of this permit on the public sidewalk. I understand that an approved administrative permit shall remain in effect for as lo as outdoor displays are permitted within the Village Review Area and the permittee remains in compliance he subject approve ermit. Signature --\;::::~~U#.1.Lc~b--J,__/?i..e::~"==s;;-i=;__---Date: </-J --(7 Certification Statement I Certify that I am the Legal Property Owner for the subject business location and that all of the above information is true and correct to the best of my knowledge. I support the applicant's request for a permit to place the subject property on the public sidewalk. I understand that an approved administrative permit shall remain in effect for as long as outdoor displays are permitted within the Village Review Area and the permittee remains in compliance with the sub. ject approved p~rmit. \cc)_ Signature ~~~ Date: L-/-/ -J 7 P-1 Page3ol6 Revised 03117 , . ('city of Carlsbad DISCLOSURE STATEMENT P-1(A) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov Applicant's statement or disclosure of certain ownership interests 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. 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 partnership, 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 (NIA) 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 necessary.) Person,___________ Corp/Part. ___________ _ Title. ___________ _ Title _____________ _ Address __________ _ Address. ____________ _ 2. OWNER (Not the owner's agent) P-1(A) 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% 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 necessary.) Person th v ~ <'\e,)Gc.1 "> l-<.,/ Corp/Part. _________ _ Title ()w he, I Title ___________ _ Address. ____________ _ Page 1 of 2 Revised 07 /1 a .. , 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the names and addresses of Mr! person serving as an officer or director of the non- profit organization or as trustee or beneficiary of the. Non Profit/Trust.________ Non Profit/Trust. _________ _ Title___________ 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? D Yes [;JNo If yes, 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. /Jt~)~\ \~ . //-r-1 7 Signature of owner/date~ .,..S-ig_n_a-tu_r_e_o_,.f-ap_p_l_ica-nV_d_a-te _____ _ Print or type name of applicant Signature of owner/applicant's a applicable/date P-1(A) Page 2 of 2 Revised 07/10