HomeMy WebLinkAbout1525 WHITE SAGE WAY; ; CB141079; Permit05-27-2014
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Pool Permit Permit No: CB141079
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC #:
Project Title:
1525 WHITE SAGE WY CBAD
POOL
2150403806 Lot#: 0
$9,773.00 Construction Type: NEW
PARKS RES- 240 SF POOL/SPA
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
05/15/2014
RMA
05/27/2014
05/27/2014
Applicant:
THE POOL DOCTOR INC
Owner:
PARKS M SETH&ERIN N
505 ALPINE TRAIL RD
ALPINE CA 91901
619 445-4977
1525 WHITE SAGE WAY
CARLSBAD CA 92011
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Electrical Fee
Plumbing Fee
strong Motion Fee
Green Bldg Standards (SB1473) Fee
Renewal Fee
Add'l Renewal Fee
other Building Fee
Additional Fees
$126.87
$0.00
$88.81
$0.00
$33.00
$33.00
$1.00
$1.00
$0.00
$0.00
$0.00
$0.00
TOTAL PERMIT FEES $283.68
Total Fees: $283.68 Total Payments To Date: $283.68 Balance Due: $0.00
Inspector:
FINAL APPROVAL
Date: ? "51' f S Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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/fixar.tinns of which vou have oreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenwise expired.
05-27-2014
City of Carlsbad
1635 Faraday Av Carlsbad.CA 92008
Storm Water Pollution Prevention Plan (SWPPP) Permit
Permit No:SW140158
Job Address:
Permit Type:
Parcel No:
Reference #:
CB#:
Project Title:
1525 WHITE SAGE WY CBAD
SWPPP
2150403806
CB141079
PARKS POOL/SPA
Lot #:
Applicant:
THE POOL DOCTOR INC
status:
Applied:
Entered By:
Issued:
Inspect Area:
Tier:
Priority:
Owner:
PARKS M SETH&ERlN N
ISSUED
05/15/2014
RMA
05/27/2014
1
L
505 ALPINE TRAIL RD
ALPINE CA 91901
619 445-4977
1525 WHITE SAGE WAY
CARLSBADCA 92011
Emergency Contact:
DON WAHL
619 445-4977
SWPPP Plan Check
SWPPP Inspections
Additional Fees
$48.00
$57.00
$0.00
TOTAL PERMIT FEES $105.00
Total Fees: $105,00 Total Payments To Date: $105.00 Balance Due: $0.00
FINAL APPROVAL
SIGNATURE
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: • PLANNING nENGINEERING • BUILDING • HEALTH • HAZMATfAPCD
CITY OF
Building Permit Application
CARLSBAD
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax:760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov It Date y\{S (Cf SWPPP
JOB ADDRESS 11— , I \ ^, sum
LOTi PHASE# I# OF UNITS |# BI(BjOOMS ^ JESi
SUITE«/SPACE«/UNIT*' Sis - Oio --^ -0(^
CT/PROJECT # .THROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
EXISTING USI PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YES N0| I
AIR CONDITIONING
YES j^NO I I
FIRE SPRINKLERS
YES I |NO| I
APPLICANT NAIVIE
Prinarv Contact
PROPERTY 01
ADDRESS
A STA*E T zie
ADDRES:
CITY 5T/WE ^ ZIP.
Cu • ^t^(^t
FAX
CITY STATE
EMAIL / \ *
FAX
I?
IC lUAMC jh.' * . /V DESIGN PROFESSIONAL CONTRAI
ADDRESS ADDRESS
CITY STATE ZIP CITY GSTATE /• .,
PHONE FAX PHONE FAX
EMAIL EMAIL
ST»]£Jja.#| CITY BUS. LIE*
Aii
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, priorto its issJeTrfBe, also recjuiJes the applicant for such permit to flle a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law {Chapter 9, ccmmendingwith Sectipn^OOO of Division 3 ofthe Business and Professions Code) orfnat he is exempttherefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Sibjects the applicant to a civil penalty of not more than five hundred dollars ($500)).
WORKERS COMPENSATION
Workers' Compensation Declaration: / hereby affimi under penalty ofpeijuiy one ofthe following declarations:
01 have and will maintain a ceitificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the perfomiance of the wort( for which this pennit is issued.
I have and will maintain |f orkers' compensation, as reguired bv Section 3700 ofthe LaborCode, forthe perfonnanqp^f tl^e vi(oryorwtiigh thispermit isjiu^^y workers' compensatiqjUBsurancexamer and policy
number are: Insurance Co!
workers compensation, as required bv Section 3700 ot
Policy No..
inqe af the workior wtiich this permit is IssuedyMy
Expiration Date _
This section need not be completed if the permit is for one hundred dollars ($100) or less.
I I Certificate of Exemption: I certify that in the perfomiance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
Califomia. WARNING: Failure to secure worMTs: compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, damagep as pmvlded for in Section 3706 of th^abor code, interest and attomey's fees.
JS^ CONTRACTOR SIGNATURE DATE
OWNER-BUILDER DBClARATiON
/ hereiiy affirm that I am exempt ftom CXintractors License Law for the following reason:
[ I I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stmcture 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).
I I I, as owner of the property, am exclusively contracting with licensed contractors to constmct 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).
• I am exempt under Sectkin _ .Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes I iNo
2.1 (have / have not) signed an application for a building pennit for the proposed work.
3.1 have contracted with the following person (firni) to provide the proposed constniction (include name address / phone / contractors' license number):
4.1 plan to provide portions of the wori(, but I have hired the following person to coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number):
5.1 will provide some of the work, but I have contrxted (hired) the following persons to provide the wori( indicated (include name / address / phone / type of work):
PROPERTY OWNER SIGNATURE D S>\iiJ\->^ AGENT DATE
:fej:TMlS SECTION FOR NO TT % » ILOING PERMITS ONtr
Is the applicant or future building oreupant required to submit a business plan, acutely hazardous materials registration forni or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? • Yes O No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O Yes O No
Is the facility to be constnicted within 1,000 leet of the outer boundary of a school site? • Yes O No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
AGENCY
I hereby aflirm that there is a construction lending agency for the perfonnance of the work this permit is issued (Sec 3097 (i) Civil Code).
Lender's Name Lender's Address
iti tie;* NT CERTtFiCAiTIO^N^
I certify that I have read tie applkatkin and state that the above infbimation is conectand that the infbnnation on the plans is accurate. I agree to complywlth all CIfy ordinances and State laws lelating to building construction.
1 hereby aulhorize representative ofthe City of Carlsbad to enter upon the above mentbned property for inspectbn purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSHA: An OSHA permit is requiied for excavations over 50' deep and demolitbn or constRictbn of stmctures over 3 stories in height.
EXPIFWTION: Every pemiit issued by the Building Oflicial under the poovisiqriaof this Code shall expire by limitatbn and become null and void if the building or vrorit aulhorized by such permit is not commenced within
180 days ftom the date of such pemiit or if Ihe buikJing or vwrt( authorized bysgcb^miit is suspended or abandoned at any time after the wort< is commenced for a period of 180 days (Section 106.4.4 Unifomi Building Code).
APPLICANT'S SIGNATURE DATE
PLAN CHECK Community & Economic
CITY OF REVIEW Development Department
1635 Faraday Avenue
CARLSBAD TRANSMITTAL Carlsbad CA 92008
wwv(/.carlsbadca.gov
DATE: 05/23/14 PROJECT NAME: PARKS RESIDENCE
PLAN CHECK NO: 1 SET#: ADDRESS: 1525 WHITE SAGE
VALUATION/SCOPE OF WORK: POOL/SPA
PROJECT ID: OB 14 1079
APN:
This plan check review is complete and has been APPROVED by the
Division.
By: K LAWRENCE 05/23/14
A Final Inspection by the Division is required Yes / No
This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the
attached checklist. Please resubmit amended plans as required.
NOTE: ONLY ITEMS THAT NEED CORRECTION/CLARIFICATION ARE MARKED X.
Plan Check Comments have been sent to: CARRIEJONES@HOTIVIAIL.CO!VI
You may also have corrections from one or more ofthe divisions listed below. Approval
from these divisions may be required prior to the issuance of a building permit.
Resubmitted plans should Include corrections from all divisions.
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
Chris.Sexton@carlsbadca.gov
/ Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.gov Gregorv.Rvan@carlsbadca.gov
Gina.Ruiz@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Cvnthia.Wong@carlsbadca.gov
Dominic.Fieri@carlsbadca.gov
Remarks:
Any oulstuiuling issues will bc marked with nn I X I Make the necessury correclions for
compliance with iipplicuble codes and standards. Siihinii corrected plans and/or specifications to
the Building division for re-sntniiittal to Ihe Engineering diinsions.
Items ihal coufonn to pemit rerpiirements are marked ivilh | ^ |
1. SITE PLAN
Provide a fully dimensioned site plan drawn to scale.
Show:
/ North arrow
/ Existing & proposed structures
/ Property line dimensions
/ Easements
Show on site plan:
/ Drainage patterns
/ Existing & proposed slopes
/ Existing topography
Retaining Walls (location and height)
Indicate what will happen with soil excavated from pool area.
Include on title sheet:
/ Site address
/ Assessor's parcel number
/ Legal description/lot number
Grading: Quantities of
Cut Fill Import Export
Project does not comply with the following engineering conditions of approval
for project no:
Conditions were complies with by: Date:
LOT NO. 23
MAP NO.
REF. NO.CT 06-27
E-37 Page 2 of 4 REV 6/2012
2. GRADING PERMIT REQUIREMENTS
The conditions that require a grading permit are found in Section 11.06.030 of the Municipal
Code.
Inadequate information available on site plan to make a determination on grading
requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and
remedial). This Information must be included on the plans. If no grading is proposed
write: "NO GRADING"
Grading Permit required. NOTE: The grading permit must be Issued and rouqh grading
approval obtained priorto issuance of a building permit. A separate grading plan prepared a
registered civil engineer must be submitted together with the completed application form attached.
/ No grading permit required.
3. MISCELLANEOUS PERMITS
ALL EQUIP OUT
OF ROW PER
APPLICANT
/ RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work
adjacent to the public right-of-way.
A separate right-of-way issued by the engineering division is required for the following:
Please complete attached right-of-way application form and return to the engineering
department together with the requirements on the attached hght-of-way checklist, at
the time of resubmittai.
Right-of-way permit and pool permit will be issued simultaneously.
E-37 Page 3 of 4 REV 5/2012
4. STORM WATER
Construction Compliance
/ Project Threat Assessment Form complete / incomplete
/ Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form
and return (SW w-iss )
Requires Tier 2 Storm Water Pollution Prevention Plan. Requires submittal of Tier 2
SWPPP, payment of processing fee and review by city.
Post-Development (SUSMP) Compliance
"/ Storm Water Standards Questionnaire complete / incomplete
Project is subject to Standard Storm Water Requirements. See city Standard Urban
Storm Water Management Plan (SUSMP) for reference.
http://www.carlsbadca.qov/business/buildinq/Documents/EnqStandsw-stds-vol4-ch2.pdf
Project needs to incorporate low impact development strategies throughout in one or
more of the following ways:
Rainwater harvesting (rain barrels or cistern)
Vegetated Roof
Bio-retentions cell/rain garden
Pervious pavement/pavers
Flow-through planter/vegetated or rock drip line
Vegetated swales or rock infiltration swales
Downspouts disconnect and discharge over landscape
Other:
5. ADDITIONAL COIVIMENTS
E-37 Page 4 of 4 REV 6/2012
^ CITY OF
CARLSBAD
STORM WATER
COMPLIANCE
ASSESSMENT
B-24
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
I am applying to the City of Carlsbad for the following type(s) of construction permit:
• Building Permit • Right-of-Way Permit
• My project is categorically EXEMPT from
the requirement to prepare a storm water
pollution prevention plan (SWPPP) because it
only requires issuance of one or more of the
following permit types:
Electrical
Fire Additional
Fire Alarm
Fixed Systems
Mechanical
Mobile Home
Plumbing
Patio/Decl(
Photo Voltaic
Re-Roofing
Sign
Spa-Factory
Sprinkler
Water Discharge
Project Storm Water Threat Assessment Criteria*
No Threat Assessment Criteria
• My project qualifies as NO THREAT and is exempt fronn the requirement to prepare a storm water pollution prevention plan (SWPPP) because
it meets fhe "no threaf assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier
Level. My project does not meet any of the High, Moderate or Low Threat criteria described below.
Tierl - Low Threat Assessment Criteria
• My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt pennit type (See list above) and the project
meets one or more ofthe following criteria:
• Results in some soil disturbance; and/or
• Includes outdoor construction activities (such as saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling).
Tier 2 - Moderate Threat Assessment Criteria
• My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria:
• Project requires a grading plan pursuantto the Carlsbad Grading Ordinance (Chapter 15.16 ofthe Carisbad Municipal Code); or,
• Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement
removal, equipment storage, refueling and maintenance areas and project meets one or more ofthe additional following criteria;
• Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or
• Disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or
• Disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse, and/or
• Construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30).
r;er3 - Significant Threat Assessment Criteria
• My project includes clearing, grading or other disturiDances to the gnjund resulting in soil disturbance totaling one or more acres including any
associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas: and/or
• My project is part of a phased devetopment plan that will cumulatively result in soil disturbance totaling one or more acres including any
associated construction staging, equipment storage, refueling and maintenance areas: or,
• My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant
potential for contributing pollutants to nearisy receiving waters byway of stomi water runoff or non-storm waler discharge(s).
/ certify to the best of my knowledge that the above
checked statements are true and correct I understand
and acknowledge that even though this project does
not require preparation of a construction SWPP, I must
still adhere to, and at all times during construction
activities for the permit type(s) check above comply
with the storm water best management practices
pursuant to Title 15 of the Carlsbad Municipal Code
and to City Standards.
"The City Engineer may authorize minor variances from the Slomi
Water Threat Assessment Criteria in special circumstances where it
can be shown that a lesser or higher Constmction SWPPP Tier Level is
warranted.
Project Address: Assessor Parcel No.
Owne'r/Owners Authorized Agent Name: {) Title: p
Owner/Owner's^^onzed Agent Signature: Date:
Citvpdncurrence: A >By; 1//' / D|ta: / i
^YES QNO (^-^^-^^/(in
B-24 Page 1 of 1 Rev.03/09
CITY OF
CARLSBAD
CONSTRUCTION THREAT
ASSESSMENT WORKSHEET FOR
DETERMINATION OF PROJECT'S
PERCEIVED THREAT TO
STORM WATER QUALITY
E-33
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
Construction
SWPPP Tier
Level
Construction Threat Assessment Criteria*
Perceived
Threat to
Storm Water
Quality
Tiers
Tier 3 - Hiah Construction Threat Assessment Criteria
High
Tiers
• Project site is 50 acres or more and grading will occur during the rainy season
• Project site is 1 acre or more in size and is located within the Buena Vista or Agua Hedionda
Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or
discharges directly to an ESA
• Soil at site is moderately to highly erosive (defined as having a predominance of soils with
USDA-NRCS Erosion factors kf greater than or equal to 0.4)
• Site slope is 5 to 1 or steeper
• Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1
through April 30).
• Owner/contractor received a Storm Water Notice of Violation within past two years
High
Tiers
Tier 3 - Medium Construction Threat Assessment Criteria Medium
Tiers
• All projects not meeting Tier 3 High Construction Threat Assessment Criteria Medium
Tier 2
Tier 2 Hiah Construction Threat Assessment Criteria
• Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or
within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA
• Soil at site is moderately to highly erosive (defined as having a predominance of soils with
USDA-NRCS Erosion factors kf greater than or equal to 0.4)
• Site slope is 5 to 1 or steeper
• Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1
through April 30).
• Owner/contractor received a Storm Water Notice of Violation within past two years
• Site results in one half acre or more of soil disturbance
High
Tier 2
Tier 2 - Medium Construction Threat Assessment Criteria
• All projects not meeting Tier 2 High Construction Threat Assessment Criteria Medium
Tierl
Tier 1 - Medium Inspection Threat Assessment Criteria
• Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, within or
directly adjacent to an environmentally sensitive area (ESA) or discharges directly to an ESA
• Soil at site is moderately to highly erosive (defined as having a predominance of soils with
USDA-NRCS Erosion factors kf greater than or equal to 0.4)
• Site slope is 5 to 1 or steeper
• Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1
through April 30).
• Owner/contractor received a Storm Water Notice of Violation within past two years
• Site results in one half acre or more of soil disturbance
Medium
Tierl
Tier 1 - Low Insoection Threat Assessment Criteria
• All projects not meeting Tier 1 Medium Construction Threat Assessment Criteria Low
Exempt - Not Applicable -Exempt
*The city engineer may authorize minor variances from the constmction threat assessment criteria in special circumstances
where it can be shown that a lesser or higher amount of stomn water compliance inspection is warranted in the opinion of
the city engineer
E-33 Page 1 of 1 REV 4/30/10
'^\wp->
STORM WATER Development Services
Land Development Engineering '^\wp-> STANDARDS Development Services
Land Development Engineering
CITY OF QUESTIONNAIRE
E-34
1635 Faraday Avenue
760-602-2750
CZ A,R. L.SOA.[D
QUESTIONNAIRE
E-34 www.carlsbadca.gov
INSTRUCTIONS:
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 Practices (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) at www.carisbadca.qov/standards.
Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision,
discretionary pennits and/or construction permits). The results of the questionnaire determine the level of storm water standards that
must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to
'Standard Stonnwater 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 stonn 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 forthe 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,
STEP1
TO BE COMPLETED FOR ALL PROJECTS 1
To determine if your project is a priority development project, please answer the following questions:
YES NO
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 penneable pavements or surfaces in
accordance with USEPA Green Streets guidance?
2. Is your project LIMITED TO retrofitting or redeveloping existing paved alleys, streets, or roads that are
designed and constructed in accordance with the USEPA Green Streets guidance?
If you answered "yes" to one or more ofthe above questions, then your project is NOT a priority development project and therefore is
NOT subject to the stornn 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.
If you answered "no" to both questions, then go to Step 2.
E-34 Page 1 of 3 Effective 6/27/13
CITY OF
CARLSBAD
STORM WATER
STANDARDS
QUESTIONNAIRE
E-34
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
r: . . «««««« .M .£^4n^ „B&,&.^. * . -
To determine if your project is a priority development project, please answer the following questions: YES NO
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
development projects on public or private land.
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? 77i/s includes commercial,
industrial, residential, mixed-use, and public development projects on public or private 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 consumption.
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
temporary parking or storage of motor vehicles used personally for business or for commerce.
6. 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 street, road, highway freeway or driveway? A street
road, highway, freeway or driveway is any paved impervious surface used for the transportation of
automobiles, trucks, motorcycles, 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 feet or less
from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the
project to the ESA (i.e. not commingles with flows from adjacent lands).*
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) codes: 5013,
5014, 5541, 7532-7534, or 7536-7539.
9. Is your project a new development that supports a retail gasoline outlet (RGO)? This category includes 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 more vehicles per day.
10. Is your project a new or redevelopment project that results in the disturtDance of one or more acres of land and
are expected to generate pollutants post construction?
11.1s your project located within 200 feet of the Pacific Ocean and (1) creates 2,500 square feet or more of
impervious surface or (2) increases impervious surface on the property by more than 10%?
If you answered "yes" to one or more of the above questions, you ARE a priority development project and are therefore subject to
implementing structural Best Management Practices (BMP's) in addition to implementing Standard Storm Water Requirements such
as source control and low impact development BMP's. A Storm Water Management Plan (SWMP) must be submitted with your
application(s) for development. Go to step 3 for redevelopment projects. For new projects, go to step 4 at the end of this
questionnaire, 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
implementing only Standard Storm Water Requirements such as source control and low impact development BMP's required for all
development projects. A Stonn Water Management Plan (SWMP) is not required with your application(s) for development. Go to step
4 at the end of this questionnaire, checic the "my project does not meet PDP requirements" box and complete applicant
information.
E-34 Page 2 of 3 Effective 6/27/13
STORM WATER Development Services
Land Development Engineering STANDARDS Development Services
Land Development Engineering
^ CITY OF
CARLSBAD
QUESTIONNAIRE
E-34
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
TO BE COMPLETED FOR REPEVELOPIDIENT PROJECTS THAT ARE PRIORITY PEVELOPgiWiNT PRqjECTS ONLY
Complete the questions below regarding your redevelopment project: YES NO
2' Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than
50% of the surface area ofthe previously existing development?
If you answered "yes," the structural BMP's required for Priority Development Projects apply only to the creation or replacement of
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 "my project meets PDP requirements" box and complete applicant information.
STEP4
CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT INFORMATION
•
(f
My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stonnwater
criteria per the SUSMP and 1 understand 1 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 STORMWATER REQUIREMENTS per
the SUSMP. As part of these requirements, 1 will incorporate low impact development strategies throughout my project.
Applicant Information and Signature Box
Applicant Narpe: '• ~Z \. 0~ Applicant Title
Applicant Signature: Date:
This Box for City Use Only
ProjectlD:^^<^^^Q^ c)
* 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 F?ARE 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 of 3 Effective 6/27/13
CITY OF
CARLSBAD
STORM WATER COMPLIANCE FORM
TIER 1 CONSTRUCTION SWPPP
E-29
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
STORM WATER COMPLIANCE CERTIFICATE
My project is not in a category of permit types exempt from the Construction
SWPPP requirements
My project is not located inside or within 200 feet of an environmentally
sensitive area with a significant potential for contributing pollutants to nearby
receiving waters by way of stomri water runoff or non-sform water
clischarge(s).
^ My project does not require a grading plan pursuant to the Carlsbad
Grading Ordinance (Chapter 15.16 ofthe Carlsbad Municipal Code)
My project will not result in 2,500 square feet or more of soils disturbance
including any associated construction staging, stockpiling, pavement
removal, equipment storage, refueling and maintenance areas that meets
one or more ofthe additional following criteria:
• located within 200 feet of an environmentally sensitive area or the
Pacific Ocean; and/or,
• disturbed area is located on a slope with a grade at or exceeding 5
horizontal to 1 vertical; and/or
• disturbed area is located along or within 30 feet of a storm drain inlet, an
open drainage channel or watercourse; and/or
• construction will be initiated during the rainy season or will extend into
the rainy season (Oct. 1 through April 30).
I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT ALL OF THE ABOVE
CHECKED STATEMENTS ARE TRUE AND CORRECT. I AM SUBMITTING
FOR CITY APPROVAL A TIER 1 CONSTRUCTION SWPPP PREPARED IN
ACCORDANCE WITH THE REQUIREMENTS OF CITY STANDARDS.
1 UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST
MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES
TO THE MAXIMUM EXTENT PRACTICABLE TO MINIMIZE THE
MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO MINIMIZE
THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED
POLLUTANTS; AND, (2) ADHERE TO, AND AT ALL TIMES, COMPLY WITH
THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP THROUGHOUT THE
DURATION OF THE CONSTRUCTION ACTIVITIES UNTIL THE
CONSTRUCTION WORK IS COMPLETE AND APPROVED BY THE CITY OF
CARLSBAD.
OWNE9^)/OWNER'S AGENT NAME (PRINT)
OWNERlS)/OWNER'S AGENT NAME (SIGNATURE)
STORM WATER POLLUTION PREVENTION NOTES
1. ALL NECESSARY EQUIPMENT AND MATERIALS
SHALL BE AVAILABLE ON SITE TO FACILITATE
RAPID INSTALLATION OF EROSION AND
SEDIMENT CONTROL BMPS WHEN RAIN IS
EMINENT.
2. THE OWNER/CONTRACTOR SHALL RESTORE
ALL EROSION CONTROL DEVICES TO
WORKING ORDER TO THE SATISFACTION OF
THE CITY ENGINEER AFTER EACH RUN-OFF
PRODUCING RAINFALL.
3. THE OWNER/CONTRACTOR SHALL INSTALL
ADDITIONAL EROSION CONTROL MEASURES
AS MAY BE REQUIRED BY THE CITY
ENGINEERING OR BUILDING INSPECTOR DUE
TO UNCOMPLETED GRADING OPERATIONS OR
UNFORESEEN CIRCUMSTANCES WHICH MAY
ARISE.
4. ALL REMOVABLE PROTECTIVE DEVICES SHALL
BE IN PLACE AT THE END OF EACH WORKING
DAY WHEN THE FIVE (5) DAY RAIN
PROBABILITY FORECAST EXCEEDS FORTY
PERCENT (40%). SILT AND OTHER DEBRIS
SHALL BE REMOVED AFTER EACH FIAINFALL.
5. ALL GRAVEL BAGS SHALL BE BURLAP TYPE
WITH 3/4 INCH MINIMUM AGGREGATE.
6. ADEQUATE EROSION AND SEDIMENT
CONTROL AND PERIMETER PROTECTION BEST
MANAGEMENT PF^ACTICE MEASURES MUST BE
INSTALLED AND MAINTAINED.
SPECIAL NOTES
PROJECT INFORMATION
Site Address: \<,^<; j^k ^ ^
Assessor's Parcel Numl$ir?i S^" 0^0 '^^'QL
Project ID: _
Constmction Pennit No.: ^--^^ /^l/ ^
Estimated Constmction Start Date
5 Project Duration. Months
Emergency Contact:
Name:
24 hour Phone:
Perceived Threat to Storm Water Quality
Q Medium
n^Low
If mediumT)ox is checked, must attach a site plan
sheet showing proposed work area and location
of proposed structural BMPs
For City Use Only
CITY
STAND
Approved By:
Date:
IAD
IWPPP
<6A-7//y
E-29 Page 1 of 3 REV 4/30/10
Erosion Control
BMPs Sediment Control BMPs
Tracking
Control
BMPs
Non-Storm Water
Management BMPs
Waste Management and Materials
Pollution Control BMPs
Best Management Practice
(BMP) Description Geotextiles & Mats Wood Mulching Earth Dikes and Drainage Swales Slope Drains Silt Fence Sediment Trap Check Dam Fiber Rolls Gravel Bag Berm Street Sweeping and Vacuuming Sandbag Barrier Storm Drain Inlet Protection Stabilized Construction Ingress/Egress Stabilized Construction Roadway Water Conservation Practices Paving and Grinding Ooerations Potable Water/Irrigation Vehicle and Equipment Cleanina Material Delivery and Storaae Material Use Stockpile Management Spill Prevention and Control Solid Waste Manaoement Hazardous Waste Manaoement Concrete Waste Manaoement CASQA Designation
Construction Activity EC-7 EC-8 EC-9 EC-11 i SE-1 SE-3 SE-4 SE-5 SE-6 SE-7 SE-8 SE-10 TR-1 TR-2 NS-1 NS-3 NS-7 NS-8 WM-1 WM-2 WM-3 WM-4 WM-5 WM-6 WM-8 V Grading/Soil Disturbance Y-
' Trenching/Excavation
r ' Stockpiling
Drilling/Boring
Concrete/Asphalt Saw
cutting
-Concrete flatwork
-Paving V'--p Conduit/Pipe Installation T
Stucco/Mortar Work
L Waste Disposal
Staging/Lay Down Area
Equipment Maintenance
and Fueling
Hazardous Substance
Use/Storage
Dewatering
Site Access Across Dirt
Other (list):
Instructions: Begin by reviewing the list of construction activities and checking the box to the left of any activity that will occur during the proposed constmction. Add any other activity descriptions in the
blank activity description boxes provided for that pun)ose and place a check in the box immediately to the left of the added activity description. For each activity descmbed, pick one or more best
management practices (BMPs) from the list located along the top of the form. Then place an X in the box at the place where the activity row intersects with the BMP column. Do this for each activity that was
checked off and for each of the selected BMPs selected from the list. For Example - If the project includes site access across dirt, then check the box to the left of "Site Access Across Dirt". Then review
the list for something that applies such as "Stabilized Constmction Ingress/Egress" under Tracking Control. Follow along the "Site Access Across Dirt" row until you get to the "Stabilized Constmction
Ingress/Egress" column and place an X in the box wiiere the two meet. As another example say the project included a stockpile that you intend to cover with a plastic sheet. Since plastic sheeting is not on
the list of BMPs, then write in "Cover with Plastic" in the blank column under the heading Erosion Control BMPs. Then place an X in the box where the "Stockpiling" row intersects the new "Cover with
Plastic" column.
To leam more about what each BMP description means, you may wish to review the BMP Reference Handout prepared to assist applicants in the selection of appropriate Best Management Practice
measures. The reference also explains the Califomia Stormwater Quality Association (CASQA) designation and how to apply the various selected BMPs to a project.
E-29 Page 2 of 3 REV 4/30/10
CITY OF
CARLSBAD
PLANNING DIVISION
BUILDING PLAN CHECK
APPROVAL
P-29
Development Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca.eov
DATE: 5-15-14 PROJECT NAIVIE: PROJECTID:
PLAN CHECK NO: CB 14-1079 SET#: 1 ADDRESS: 1525 White Sage Way APN:
^ This plan check review is complete and has been APPROVED by the
Division.
By: Chris Sexton
A Final Inspection by the Planning Division is required • Yes ^ No
You may also have corrections from one or more of the divisions listed below. Approval
from these divisions may be required prior to the issuance of a building permit.
Resubmitted plans should include corrections from all divisions.
Q This plan check review is NOT COMPLETE. Items missing or incorrect are listed on
the attached checklist. Please resubmit amended plans as required.
Plan Check APPROVAL has been sent to: carriejones@hotmail.com
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
X Chris Sexton
760-602-4624
Chris.Sexton@carlsbadca.gov
1 1 Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.fiov
1 1 Greg Ryan
760-602-4663
Gregorv.Rvan@carlsbadca.fiov
1 1 Gina Ruiz
760-602-4675
Glna.Ruiz@carlsbadca.fiov
1 Linda Ontiveros
760-602-2773
Linda.Ontlveros@carlsbadca.fiov
Q Cindy Wong
760-602-4662
Cvnthia.Wonfi@carlsbadca.gov
• • 1 1 Dominic Fieri
760-602-4664
Dominic.Fierl@carlsbadca.fiov
Remarks: