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HomeMy WebLinkAbout1911 CALLE BARCELONA; 152; CB080673; Permit-07-20-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No Building Inspection Request Line (760) 602-2725 CB080673 Job Address Permit Type Parcel No Valuation Occupancy Group Project Title 1911 CALLE BARCELONA CBADSt 152 Tl Sub Type 2550120400 Lot# $0 00 Construction Type Reference # FREE PEOPLE- INSTALL STORAGE RACKS FOR CLOTHING COMM 0 NEW Applicant MACKENZIE KECK 434 SANDSHORE RD HACKETTSTOWN NJ 07840 9088501006 Status ISSUED Applied 04/15/2008 Entered By LSM Plan Approved 07/20/2009 Issued 07/20/2009 Inspect Area Plan Check# Owner BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L C/O DELOITTE TAX LLP PO BOX 131071 CARLSBAD CA 92013 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot Water Con Fee Meter Size Add'l Pot Water Con Fee Reel Water Con Fee Green Bldg Stands (SB1473) Fee $0 00 Meter Size $0 00 Add'l Reel Water Con Fee $0 00 Meter Fee $240 00 SDCWA Fee $0 00 CFD Payoff Fee $100 PFF (3105540) $0 00 PFF (4305540) $0 00 License Tax (3104193) $0 00 License Tax (4304193) $000 Traffic Impact Fee (3105541) $000 Traffic Impact Fee (4305541) $0 00 PLUMBING TOTAL $0 00 ELECTRICAL TOTAL $0 00 MECHANICAL TOTAL $0 00 Master Drainage Fee Sewer Fee $0 00 Redev Parking Fee $0 00 Additional Fees 99 HMP Fee TOTAL PERMIT FEES $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 99 $241 00 Total Fees $241 00 Total Payments To Date $241 00 Balance;Due $000 Inspector FINAL APPROVAL Date 1 /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 tees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired City of Carlsbad 1635 Faraday Ave Carlsbad CA 92008 760-602-2717 / 2718 / 2719 Fax 760-602-8558 ' Building Permit Application Plan Check No. Est. Value Plan Ck. Deposit JOB ADDRESS CVPROJECT*' SUITE#/SPACE#/UNIT# #"OF UNITS H #"BEDROOMS CONSTf"TYPE .1 OCC GROUP# BATHROOMS TENANT BUSINESS.NAME DESCRIPTION OF WORK KK 7031S Business and Professions Code Any City or County which requires a permit to construct alter improve demolish or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law {Chapter 9 commending with Section 7000 of Division 3 of the Business and Professions Code} or that he H exempt therefrom, and the basis for the alleged exemption Any violation of Section 70315 by any applicant for a permit subject: the applicant to a civil penalty of not more than live hundred dollars {$500}) Workers' Coinpensation Declaration / hereby affirm under penalty of perjury one of the following declarations I have and will maintain i certificate of consent to self Insure for workers' compensation as provided by Section 3700 of the Labor Code for the performance of the work for which this permit is issued I have and will maintain workers' compensation as number are Insurant r.n This section need not be completed if the permit is for one hundred dollars ($100) or less G Certificate of Exemption I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damages as provided in Section 3706 of the Labor code, interest and attorney's fees bisection 3700 of the Labor Code for the performance, of the work for which this permit is issued My workers compensatiorunsuijnce^arrier and policy *T <cL ^ ^£> Policy No ^.Af^^-fL^ Expiration Date &//7 /Z<£%>Q I hereby affirm that I am exempt from Contractor s License Law for the following reason C1 I as owner of the properly or my employees wilh wages as their sole compensation will do the work and the structure is not intended or offered for sale (Sec 7044 Business and Professions Code The Contractor s License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees provided that such improvements are not intended or offered for sale If however the building or improvement is sold within one year of completion the owner builder will have the burden of proving that he did not build or improve for the purpose of sale) n I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code The Contractor s License Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contractor(s) licensed pursuant to the Contractor s License Law) n I am exempt under Section. .. Business and Professions Code for this reason 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement D Yes Cl No 2 I (have / have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors license number) 4 I plan to provide portions of the work but I have hired the following person to coordinate supervise and provide the major work (include name / address / phone / contractors license number) 5 I will provide some of the work hut I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work) PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration form or risk management and prevention program under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act' O Yes Q No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' n Yes O No Is the facility to be constructed within 1 000 feet of the outer boundary of a school site7 O Yes D No IF ANY OF THE ANSWERS ARE YES, / EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec 3097 (i) Civil Code) Lender's Name Lender's Address I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate I agree to comply with all City ordinances and State laws relating to building construction thereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSH A An OSH A permit is required for excavations over 5'0 deep and demolition or construction of structures over 3 stones in height EXPIRATION Every permit issued by the Building Official under Itie provisions of this Code shall expire by limitation and become null and void if the building or work authonzed by such permit is not commenced within 180 days from the date of such permit or if the buitdmcior work authored by such permrtjs suspended or/abandoned at any time after the work is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) -^APPLICANT'S SIGNATURE MjjJ/j/t.t // / ^_ (--K/'M/7b DATE City of Carlsbad Bldg Inspection Request For 07/21/2009 Inspector AssignmentPermit# CB080673 Title FREE PEOPLE- INSTALL STORAGE Description RACKS FOR CLOTHING Type Tl Sub Type COMM Job Address 1911 CALLE BARCELONA Suite 152 Lot 0 Location Inspector OWNER BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L Owner Remarks Store opens at 10 30am Not sure what is Phone 3108898411 Total Time Requested By CARI Entered By CHRISTINE CD Description Act Comments 14 Frame/Steel/Boltmg/Weldmg Date Comments/Noticfes/Holds Associated PCRs/CVs Original PC# CV040459 CLOSED Z- BANNER, CV090283 OPEN H-STORAGli RACKS W/O PLKMIT, Inspection History Description Act Insp Comments EsGil Corporation In (Partnership with government for Quitting Safety DATE 5/22/09 JURISDICTION City of Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO O80673 SET II PROJECT ADDRESS 1911 Calle Barcelona Suite #152 PROJECT NAME Storage Racks for Free People The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person The applicant's copy of the check list has been sent to XI Esgil Corporation staff did not advise the applicant that the plan check has been completed Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Telephone # Date contacted (by V) Fax # \j/Mail Telephone Fax IrfRexson XI REMARKS 1 City to field verify that the path of travel from the handicapped parking space to the rack area and the bathcooms serving the rack area comply with all the current disabled access requirements 2 Fire Department approval is required By David Yao Enclosures EsGil Corporation D GA D MB D EJ D PC 5/21 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 4 (858)560-1468 4 Fax (858) 560-1576 EsGil Corporation In Partnership -with government for Quitting Safety DATE 4/25/O8 JURISDICTION City of Carlsbad Q PLAN REVIEWER G FILE PLAN CHECK NO 080673 SET I PROJECT ADDRESS «£i Calle Barcelona Suite #152 PROJECT NAME Storage Racks for Free People The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck IXl The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person X3 The applicant's copy of the check list has been sent to Mike Stout 434 Sandshore Road HacKetts Town, New Jersey 07840 Esgil Corporation staff did not advise the applicant that the plan check has been completed Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted, Mike Stout Telephone # 908-319-2552 Date contactedtf/lf/V' (by^^£p Fax # £jyiail U^Telephone / Fax Jn Person REMARKS By David Yao Enclosures Esgil Corporation D GA D MB D EJ D PC 4/17 9320 Chesapeake Drive, Suite 208 * San Diego, California 92123 4 (858)560-1468 + Fax (858) 560-1576 City of'Carlsbad 080673 4/25/08 GENERAL PLAN CORRECTION LIST JURISDICTION City of Carlsbad PLAN CHECK NO O80673 PROJECT ADDRESS 1191 Calle Barcelona Suite #152 DATE PLAN RECEIVED BY DATE REVIEW COMPLETED ESGIL CORPORATION 4/17 4/25/08 REVIEWED BY David Yao FOREWORD (PLEASE READ) This plan review is limited to the technical requirements contained in the International Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and disabled access This plan review is based on regulations enforced by the Building Department You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department or other departments The following items listed need clarification, modification or change All items must be satisfied before the plans will be in conformance with the cited codes and regulations The approval of the plans does not permit the violation of any state, county or city law • To facilitate recheckmg, please identify, next to each item, the sheet of the plans upon which each correction on this sheet has been made and return this sheet with the revised plans • Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located on the plans Have changes been made not resulting from this list? D Yes a No City of Carlsbad O80673 4/25/O8 1 Please make all corrections, as requested in the correction list Submit three new complete sets of plans for commercial/industrial projects (two sets of plans for residential projects) For expeditious processing, corrected sets can be submitted in one of two ways 1 Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave , Carlsbad, CA 92008, (760) 602-2700 The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments 2 Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468 Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments NOTE Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete 2 Provide a note on the plans indicating if any hazardous materials will be stored and/or used within the building which exceed the quantities listed in IBC Tables 307 7(1) and 307 7(2) 3 The tenant space and new and/or existing facilities serving the remodeled area must be accessible to and functional for the physically disabled Show a path of travel from the handicapped parking space to the shelving area and the bathrooms serving the shelving area comply with all the current disabled access requirements Title 24, Part 2 4 Obtain Fire Department approval 5 Indicate the clearance from the new racks to the existing building walls and building columns 6 Remove the note on the rack layout plan that the rack will be anchored to the walls, unless calculations and details are provided to show the walls are adequate to resist the rack lateral loads (RMI 1 4 10 ) 7 Does the storage racks open to the general public'? 1=1 5? Please note on the plan (RMI 272) 8 The calculation provided shows the 11 ga double rivet beam only Please provide calculation to show the beam (detail 2) is adequate 9 Provide calculation to show the L post is adequate to support the proper load 10 Recheck the base plate anchors as follows Check the transverse seismic for overturning with only the top shelf loaded with the force acting through the center of gravity of the top load per RMI 276 City of Carlsbad 080673 4/25/08 11 Check the slab stress for the maximum transverse overturning axial load Show the slab thickness on the plans per the calculations Check the maximum slab stress under the base plate per Section 1915 4 2 12 The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123, telephone number of 858/560-1468, to perform the plan review for your project If you have any questions regarding these plan review items, please contact David Yao at Esgil Corporation Thank you END City of Carlsbad 080673 4/25/08 VALUATION AND PLAN CHECK FEE JURISDICTION City of Carlsbad PLAN CHECK NO 080673 PREPARED BY David Yao DATE 4/25/O8 BUILDING ADDRESS 1191 Calle Barcelona Suite #152 BUILDING OCCUPANCY TYPE OF CONSTRUCTION BUILDING PORTION shelvings Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA (Sq Ft) cb Valuation Multiplier By Ordinance Reg Mod VALUE ($) Plan Check Fee by Ordinance _^_j Type of Review D Complete Review $240 00 .[Repetitive Fee ~^T; Repeats * Based on hourly rate Comments D Other m Hourly Esgil Plan Review Fee Structural Only Hours $192 00 Sheet 1 of 1 macvalue doc Carlsbad Fire Department COPY Plan Review Requirements Category TI, COMM Date of Report 06-03-2009 MACKENZIE KECK Reviewed by Name Address 434 SANDSHORE RD HACKETTSTOWN NJ 07840 Permit # CB080673 Job Name FREE PEOPLE- INSTALL STORAGE Job Address 1911 CALLE BARCELONA CBAD St 152 INCOMPLET1 fcTcietermine compliance with the applicable codes and/or standards PleaseTe^iew caretully all comments attached Please resubmit the necessary plans and/or specifications, with changes "clouded", to this office for review and approval Conditions: Cond CON0003498 [MET] THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW Entry 06/03/2009 By GR Action AP BY G OHANIAN DATE 5' J5'°1 SUBJECT RACJK DEj&GlN & ENGINEERING do. 412 TIKlT BROADWAY, 0UITE #204 QLEttDALE, dA. 91204 TEL:(818)240-3810 FAX:(818)240-38l3 SHEET N°' JOB NO. 1*9 If 11 7 _ I °\ \o \\ To CKGCk. (b RfC,To& A/t> THC BY . G OHANIAN DATE 5-14-09 . SUBJECT DESIGN & ENGINEERING! do. 412 WEElT BROADWAY, $UITE #204 QLENDALE, <JA. 91204 TEL:(818)240-3810 FAX:(818)240-3813 SHEET NO. 1 JOB NO. RD-14149 STRUCTURAL CALCULATIONS OF STORAGE SHELVING FOR: FREE PEOPLE 19O5 CALLE BARCELONA, SUITE #152 CARLSBAD, CA. 92OO9 PER CBC 2OO7 EDITION STORAGE SHELVING CAPACITY 50 #/ LEVEL CALCS 1 THRU 4 DRAWINGS RD-14149 BY ' G OHANIAN DATE 5-14-09 SUBJECT RAdK DESIGN & ENGINEERING 412 ffE^T BROADWAY, jgUTTE #204 (iLENDALE, (JA. 91204 TEL:(818)240-3810 FAX:(818)240-3813 SHEET NO. 2 JOB NO. RD-14149 1 t- — •)• FOLD UNITS J8" SIDE VIEW 30" 00o 30" Z3 FOLD MOBILE SHELVING ooO Jf 3Q" y fl^r HANGING SHELVING 50 #/ LEVEL 25 #/ BEAM M_ 5Q"xQ25K^ 09-K 8 SR=-§fK= 004<05 DOUBLE RIVET BEAM t=11 GA lx=05 Sx=05 DOUBLE RIVET BEAM J_3/32" t=14 GA lx=11 Sx=12 FY=36KS1 SEISMIC DESIGN V=-R x W CBC 2007, RMI SPECS ASCE 7 (SEC. 155.3) 1=1 NO PUBLIC ACCESS R=6 MOM CONN SDS =-81 W=D.L +L.L LOAD PER COLUMN p=_8x^5J=2K V== 04 K BASE SHEAR PER COLUMN 02 K 02' = 004< 12 04" BY ' G OHANIAN DATE 5-14-09 SUBJECT DEisJidN & ENGINEERING! do. 412 WEEJT BROADWAY, ^tUITE #204 QLENDALE, CJA. 01204 TEL:(818)240-3810 FAX:(818)240-38l3 SHEET NO. 3 JOB NO. RD-UU9 COLUMN "T" POST •^W A= 40 COLUMN 'L' POST A= 2'•' Kl 45 „ KJ 45 117 \ ,_ /j-jj^t=075- Lin- OB rx 54 - lmln-04 rx .4 U U Smln= °8 F = 1 1y __ _ __ Lj_ ll_ __ V Q " \ r ln= ^4 i i pa =Fa *tL 31/4" I o=75 ° ° /f A KSI S = 04 ,- c KSI°mln u^ Fn= 5U v mln— i^^ = 4K m'n Pa=FaxA = 1K Q= 75 a FY=36 "SI Ma =8^= 1 8"K FY=36 KSI Ma =5^ Fb= 9 "K COMBINED STRESS RATIO P u 7 a_i 1" i-i_ *J i & — C "7 j* 4 m P^ + M-Q--4- + T8- 57<133 l; + ^=T- + ^=7<1-33 MOMENT AT BEAM CONNECTION K V M t _ 9+ 6 _ 75"K BEAM -I 252x3 14 _n , . -K F • ,UR,VET- 4 x80x4-15 L ^ I - a =1 5Kx1 5"x1 33=3 0"K 'CONN 25"0 RIVET -^ FY=80KSI / 0 yi Hi - -4f ^n r> ^ 0 ^ !8L o _ ri COLUMN BASE PLATE ANCHOR SHEAR = .04K USE (1)-1/4"0 ANCHOR AT 'L'-POST, (2)-1/4" AT T POSTS PER BASE PLATE, 2" EMB POWERS SCREW TYPE (ESR-1678) OR APPROVED EQUAL, (NO SPECIAL INSPECTION REQ'D) © . 1 1/4" © t=UGA OVERTURNING MQT= 04Kx2x108"x 5x1 15 = 4 9"K MR= 3Kx18"= 54"K NO UPLIFT OVERTURNING TOP LEVEL LOADED ONLY MOT= 01Kx2x108"=2 2"K MR= 15Kx18= 27"K NO UPLIFT MOBILE SHELVING ANTI TIP TRACK ANCHORD TO FLOOR W/ 1/4"0 ANCHORS @ 24" o.c ANTI-TIP BOLTED TO MOBILE CARRIAGE W/ (2) 1/4"0 BOLTS SHELVING POST CONNECTED TO CARRIAGE W/ (2) 1/4"0 TEK SCREWS PER POST BY . G OHANIAN DATE 5-14-09 SUBJECT & ENGINEERING! do. 412 WEEJT BROADWAY, (SlUTTE QLENDALE, CA. 91204 TEL:(818)240-3810 FAX:(818)240-3813 SHEET NO. 4 JOB NO. RD-U149 CHECK SLAB 300 * n' ^14/1 A^D"1000 ~ 3 3x144-43 V43 =6"r ~~ 1 j**|AIWWA A 1 *. ~~ y *T "\ 12 j 2 L o S= 12^5 = 50 300* 5" CONCRETE SUB ~T 2500 PSI CONC /~1000 PSF SOIL •v.l . 1 .5"} 1 5" , 3" 6" = 1 8< 1 6 V2500 =80 ACORD. CERTIFICATE OF LIABILITY INSURANCE ft"^ PRODUCER Mitchell Insurance Agency 29 Trinity street Newton NJ 07860 Phone 373-383-5800 Fax 973-579-3916 INSURED The Mackenzie Companies, Inc.Mackenzie Keck, Inc301 Roundhill DriveRockaway NJ 07866 DATE (MM/DD/YYYY) 06/06/09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURER A Safeco Ins of America INSURERS Scottsdale Insurance Co INSURER C s.l«ctiv» Iruunnc. Caiptny INSURER D INSURER E NAIC# 816 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INbftLTR B C C A C AULM.NSRC X TYPE OF INSURANCE GENERAL LIABILITY X^ X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE |x | OCCUR Blanket AI GEN I. AGGREGATE LIMIT APPLIES PER~i POLICY n5§& FK AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY JCj OCCUR | | CLAIMS MADE X DEDUCTIBLE RETENTION $ 0 WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes dQscnbe under SPECIAL PROVISIONS below OTHER POLICY NUMBER BCS0015528 S 1758455 S 1758455 01WC05452630 WC 7254611 ruLH,T errti* HVSDATE (MWDD/YY) 07/27/08 05/24/09 05/24/09 06/15/08 05/24/09 POLICY EXPIRATIONDATE (MftUDDftY) 07/27/09 05/24/10 05/24/10 01/16/09 05/24/10 LIMITS EACH OCCURRENCE LVWIAWI 1 VJ Kt[M 1 tU PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL * ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EAACC AGG EACH OCCURRENCE AGGREGATE „ 1 wC STATU-X | TORY LIMITS OTH-ER EL EACH ACCIDENT EL DISEASE -EA EMPLOYEE E L DISEASE - POLICY LIMIT $ 1,000,000 $100,000 $ Excluded $1,000,000 $2,000,000 $2,000,000 $1,000,000 $ $ $ $ $ $ $20,000,000 $20,000,000 $ $ $ $1,000,000 $1,000,000 $1,000,000 Job Name -Free People (J#2400) Location -The Forum at Carlsbad 1911 Calle Barcelona, Suite 152 Carlsbad, CA 92008 City of Carlsbad is included as additional insured base on written contractual agreement Respects to the General Liability policy subject to terms, conditions & exclusions CERTIFICATE HOLDER CANCELLATION CITJTCAR City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER FTS AGENTS OR REPRESENTATIVES AUTHORIZED REPRE3^rTATTVE .« n -. /J ^[^ ^^^~m ^^J ^rf^^f^^^^^^^f*^^AjaZPU 7v //7Z*Cte^3 ACORD 25 (2001/08)© ACORD CORPORATION 1988 Check A License Contractor's License Detail Page 1 of 2 Skip to CSLB Home | Content | Footer | Accessibility I i Search HCONTRACTORS STATE LICENSE BOARD BUILDING OFFICIALS GENERAL INFO About CSLB CSLB Newsroom Board and Committee Meetings Disaster Information Center CSLB Library Frequently Asked Questions Online Services • Check A License or HIS Registration • Filing a Construction Complaint • Processing Times • Check Application Status • Search for a Surety Bond Insurance Company • Search for a Workers' Compensation Company How to Participate <LO DISCLAIMER- A license status check provides information taken from the CSLB license database Before relying on this information, you should be awai the following limitations • CSLB complaint disclosure is restricted by law (B&P 7124 6) If this entity is subject to pu complaint disclosure, a link for complaint disclosure will appear below Click on the link oi obtain complaint and/or legal action information • Per B&P 7071 17, only construction related civil judgments reported to the CSLB are disc • Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitr. • Due to workload, there may be relevant information that has not yet been entered onto th license database License Number Business Information Entity Issue Date Expire Date License Status Classifications Bonding 894841 Extract Date 03/10/21 MACKENZIE KECK INC 434 SANDSHORE ROAD HACKETTSTOWN, NJ 07840 Business Phone Number (908) 850-1006 Corporation 04/19/2007 04/30/2009 This license is current and active All Information below should b reviewed CLASS DESCRIPTION GENERAL BUILDING CONTRACTOR CONTRACTOR'S BOND This license filed Contractor's Bond number 6461765 in the amoui $12,500 with the bonding company Effective Date 04/18/2007 BOND OF QUALIFYING INDIVIDUAL Workers' 1 This license filed Bond of Qualifying Individual number 64776 for AMANDA WILLIAMS GADDY in the amount of $12,500 w the bonding company AMERICAN STATES INSURANCE COMPANY Effective Date 03/05/2007 This license has workers compensation insurance with the http //www2 cslb ca gov/General-Information/interactive-tools/check-a-hcense/License+ 03/10/2008 Check A License Contractor's License Detail Page 2 of 2 Compensation SAFECO INSURANCE COMPANY OF AMERICA , Policy Number 01WC05452630 Effective Date 06/15/2007 Expire Date 06/15/2008 Workers' Compensation History 1 Personnel'Lists' .Consumers | Contractors | Applicants | Journeymen [ Public Works ;| Building Officials | General Info '( • ' •-,-.. • .'. CSLBHome | Conditions of Use fPnvaqyl. Contact CSLB :. .;,•.>; Copyright © 2007 State of California http //www2 cslb ca gov/General-Information/interactive-tools/check-a-hcense/License+ 03/10/2008 CB080673 1911 CALLE BARCELONA 152 Approved Building Planning Engi net-ring Fire Health Hu/Mat/Air Quality ^Z6A x!///v' A/M ^ '/i/01/ ' Comments Date Building Planning Engineering Fire #p?n Formt/Feet School CFD PFK P E & M Special Insp Fire Sewer Y N V N N N N N N Fees Complete . Application & Related Docs Complete .