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HomeMy WebLinkAbout1923 CALLE BARCELONA; 138; CB080570; PermitCity of Carlsbad 1635 Faraday Ay, Carlsbad, CA 92008 04-10-2008 Miscellaneous Permit Permit No CB080570 Building Inspection Request Line (760) 602-2725 Job Address 1923 CALLE BARCELONA CBAD St 138 Permit Type MISC Subtype OTHER Status ISSUED Parcel No 2550120400 Lot# 0 Applied 04/01/2008 Valuation $24,000 00 Entered By MDP Reference* Plan Approved 04/10/2008 PC# Issued 04/10/2008 Inspect Area Project Title SPEC SUITE GLU LAM BEAM REINFORCEMENT Applicant Owner SHINER DAN BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L C/ODELOITTETAXLLP 3000 E MIRA LOMA PO BOX 131071 ANAHEIM CA 92806 CARLSBAD CA 92013 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees PLAN CHECK PERMIT $14713 $226 35 $000 TOTAL PERMIT FEES $373 48 Total Fees $373 48 Total Payments To Date $373 48 Balance Due $0 00 BUILDING PLANS - IN STORAGE ATTACHED FINAL APPROVAL Inspector 1 f/fft/N Date .ff/7/^ Clearance NOTICE Please take NOTICEihat approval of your project includes the Imposition of fees dedications reservations y 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 feej/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 iformation with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will ba 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 APPL> to water ^nd sewer connection fees and capacity changes nor planning zoning grading or other similar application processing or service fees in connection with this projp J NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations ias previously otherwise expired City of Carlsbad 1635 Faraday Ave , Carlsbad CA 92008 760 602 2717 / 2718 / 2719 Fax 7606028558 Building Permit Application Plan Check No ofi-sno Est Value Plan Ck Deposit Date SUITE#/SPJC£#/im!T# PHASE'S" f#"OFTJNitS~~[» BEDROOMS #~BATHR&OMS" '•"ffENANTBUSiNESS NAME CONSTR TYPE OCC GROUP EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME ADDRESS CITY STATE ZIP PHONE i FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC # PATIOS (SF) DECKS (SF) FIREPLAC YESD #. APPLICANT NAME ADDRESS >OOO £«•* AV J~e\,c>** CITY . PHONE EMAIL CONTRACTOR BUS NAME £ 9S Xw£ ADDRESS J\ \A6wv, e,1^V\ PHONE EMAIL STATE LIC # 3mH7,2L E AIR CONDITIONING FIRE SPRINKLERS NO a YES n NO n YES a NO n / >JcK\ULL 4. Sd * ^W [FAX C*wsWt;«A >Cc^ STATE ZIP£A ^;XWG> FAX CLASS CITY BUS LIC # IS Appl.W (Sec 70315 Business and Professions Code Any City or County which requires a permit to construct alter, improve demolish or repair any structure, prior to r:s issuance also requires the applicant for such permit to file afsigrfed 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 is exempt therefrom and the basis for the alleged exemption Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}) Worker* Compensation Declaration / hereby affirm under penalty of perjury one of (he following declarations n I have and will maintain a certificate of consent to self insure for workers compensation as provided by Section 3700 of the Laboi Code for the performance of the work for which this permit is issued §T I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for which this permit is issued My workers compensation insurance carrier and policy number are Insurance Co C—C^C-fHyy fa-g<A gsfc-V 'JUxS £.0 Policy No f AilC, C) l^f}(~) ^.^6>O Expiration Date "7" I "£>? This section need not be completed if the permit is for one hundred dollars ($100) or less n 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^vicff d/fpr in See}j9n 3706 of the Labor code interest and attorney s fees &'KE&"iVi??iSt*iy!*!i>''lii£i».' ,-;-W •• ,>"'.**(«" ••"l^-* '•''!ffS^V^'^^ss ^•^^Igf^il^liM.H^i^^'glgra^,;"-. %^Cff! / hereby affirm that I am exempt from Contractor s License Law for the following reason H I as owner of the property or my employees with 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 lhat he did not build or improve for the purpose of sale) O I as owner of the property am exclusively contracting with licensed contractors to construct the proiect (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 O Yes n 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 but 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 E^No Is the applicant or future building occupant required to obtain a permit fromthe air pollution control district or air quality management district' D Yes Is the facility to be constructed within 1 000 feet of the outer boundary of a school site7 O Yes 5J-No IF ANY OF THE ANSWERS ARE YES EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT ^Y ^^ : ~ • ~J%'- ' .. .O'T*^- ff^,- ~a~.r\ . .. .jh_]~v ,;A 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 agref to comply with all City ordinances and State laws relating to building construction I hereby authorize representative of the City of Carlsbad to enter upon the above mentoned 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 OSHA An OSHA 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 the provisions of (his Code shall expire by limitation and become null and void if the building or work autfionzed by such permit is not commenced within 180 days from the date of such permit or if the building or vyork authorized by such permit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 106 4 4 Uniform Building Code) PLICANT S SIGNATURE DATE UNSCHEDULED BUILDING INSPECTION INSPECTOR PERMIT# OS- JOB ADDRESS DESCRIPTION CODE DESCRIPTION m PLAN CHECK # ACT COMMENTS Inspection List Permit* CB080570 Type MISC OTHER SPEC SUITE GLU LAM BEAM REINFORCEMENT Date Inspection Item Inspector Act Comments 05/07/2008 14 Frame/Steel/Boltmg/Weldm PY AP 05/07/200819 Final Structural PY AP Thursday May 08 2008 Page 1 of 1 EsGil Corporation In "Partnership -with government for (Buibfing Safety DATE APRIL 8, 2008 a APPLICANT JURISDICTION CARLSBAD U PLAN REVIEWER a FILE PLAN CHECK NO 08-057O SET I PROJECT ADDRESS 1923 CALLE BARCELONA PROJECT NAME THE FORUM OF CARLSBAD The plans transmitted herewith have tfeen corrected where necessary and substantially comply with the jurisdiction's building codes XI 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 ) Fax # Mail Telephone Fax In Person XI REMARKS # 1) A note to the building official that the relocation of columns and footings are under a separate permit, #2) Applicant to note on plans that ine post tensionmg operations requires Special Inspection By ALI SADRE Enclosures Esgil Corporation D GA D MB D EJ D PC 4/3 9320 Chesapeake Drive Suite 208 * San Diego, California 92123 + (858)560-1468 *• Fax (858) 560-1576 VALUATION AND PLAN CHECK FEE JURISDICTION CARLSBAD PLAN CHECK NO O8-O57O PREPARED BY ALI SADRE DATE APRIL 8, 20O8 BUILDING ADDRESS 1923 CALLE BARCELONA BUILDING OCCUPANCY B/S1 TYPE OF CONSTRUCTION V-B BUILDING PORTION STRUCTURAL RETROFfT Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA ( Sq Ft ) CB RIHn Pprmit- Fpp h\/ Ordinanrp •» Valuation Multiplier By Ordinance Reg Mod VALUE ($) "^ 24,000 $226 35 Plan Check Fee by Ordinance •*• Type of Review I? Complete Review Structuial Only f" Repetitive Fee ^ Repeats r Other Hourly Hour* Esgil Plan Review Fee Comments $14713 $12676 Sheet 1 of 1 macvalue doc PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 0%~S~1O DATE -- ADDRESS 3-k RESIDENTIAL TENANT IMPROVEMENT RESIDENTIAL ADDITION MINOR « $10,000.00) PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ^ ENGINEER DATE Dots/Mlsfonns/plannmg Engineenng Approvals PLUMP ENGINEERING INC STRUCTURAL CALCULATIONS Client SPS Project The Forum of Carlsbad - GLB Modification Location 1923 Calle Barcelona, Carlsbad, CA Building Code 2007 CBC Plump File No 080337 By RP Date March 26, 2008 Revisions These calculations not valid unless signed and sealed in space above 914 E Katella Avenue, Anaheim, CA 92805 (714) 385-1835 Fax (714) 385-1834 Results for LC 1, DL+LL+PRETENSION ! Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad Mar 26, 2008 at 2 33PM 080337 r3d Results for LC 1, DL+LL+PRETENSION Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad Mar 26, 2008 at 2 33 PM 080337 r3d - 6k/ft Loads LC1, DL+LL+PRETENSION Results for LC 1, DL+LL+PRETENSION Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad Mar 26, 2008 at 2 33 PM 080337 r3d -312k/ft Loads BLC 1, DL Results for LC 1, DL+LL+PRETENSION Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad Mar 26, 2008 at 2 34 PM 080337 r3d - 288k/ft Loads BLC 2, LL Results for LC 1, DL+LL+PRETENSION Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad i Mar 26, 2008 at 234PM [080337 r3d r beam Mv Shape 6 75X25 5FS Material BEAM Length 43 55 ft Joint N6 J Joint N5 LC1 DL+LL+PRETENSION Code Check 0616 (bending) Report Based On 97 Sections I | 12131 at6 351 ft A • k ii -10 647 at. 42 643. ft j _Ii K-Tl 07 at 6 351 ft fa — J5fe.: -^^-^sms^.^ ks, - 062 at 42 643 ft I | | i i 019at8619ft i-> /'""S / •°y / \ 7 m / \ / r\-. tn/ \y -183 at Oft 12 544 at 42 643 ft r\ f\ I\i ^ ^-, i i, \lv - • k i ' ^-*~. I I -11 188 at 5 897 ft 55 549 at 5 897 ft J Mw If ftp : }. ^ iviy K-TI • ---i-- '' -*--! tf ft 'HI*. v^_... s • '•': '-' K-lt -19 095 at 31 302ft 911 at 5 897 ft t. : ft *--^rvtr*Ff&3?r'W^^ ksi -911 at 5 897 ft NDS 2005 Code Check Max Bending Check 0616 Max Shear Check 0 543 (y) Location 5897ft Location 42643ft Equation 39-3 Max Defl Ratio L/3180 CD 1 RB 17102 CL 1 CV 1 Cr 1 Cfu 1 07 CP 956 (ksi) Cm Ct CF Y-Y Z-Z Fc1 1152 73 1 i 1 Lb Oft 4355ft Ft1 88 8 1 1 I le/d 0 13321 Fb1' 148 8 1 1 ! Sway No No Fb2' 1241 8 1 1 I r Ernrima TOD Oftp , ..„. ___ , i_e Dcnaing i op u n184 a/;) n ; 1 P Ppnrlmn Rnt AT. 11 ftE1 14994 833 j 1 ! Lc-Bonding Hot 43 5^ ft i Beam /W7 Shape 6 75X25 5FS Material BEAM Length 43 55 ft 1 Joint N6 J Joint N5 LC2 DL+PRETENSION Code Check 0 321 (bending) Report Based On 97 Sections 9 865 at 6 351 ft -8 659 at .42 643 ft T it ftK-TI 057 at 6 351 ft - 05 at 42 643 ft 176 at 21 775 ft I tjy / •* m QZ — in -214 at Oft : 6 523 at 42 643 ft f r--. !W' -^ I — --^ I i, • \/-r ... \f=.-;-,' "^cr-r K vz K ; -5 818 at 5 897 ft 28 886 at 5 897 ft A i/ x/r-. - l. J-. ••- If ft / '•"• ' s-^— '"' ' X /.- iv^ •»;-,. \ A ; Mz ^--^------ :~i:-..i^^U k-ft - 877 at 34 477 ft 474 at 5 897 ft I I ft v '~~?TJK""T; " T^^.'j''«^">a-7 f ksi ft '' f K.f||: . S.VVj-...M-/f * . V - 474 at 5 897 ft NDS 2005 Code Check Max Bending Check 0 321 Max Shear Check 0 282 (y) Location 6 351 ft Location 42 643 ft Equation 39-3 Max Defl Ratio L/1747 CD 1 RB 17102 CL 1 CV 1 Cr 1 Cfu 1 07 CP 956 (ksi) Cm Ct CF Y-Y Z-Z Fc1 1152 73 1 1 Lb Oft 4355ft Ft' 88 8 1 1 le/d 0 13321 Fb1' 1 48 8 1 1 i Sway No No Fb2' ! 1241 8 i 1 1 IrPrnrtmnTnn fl ftp , : ._. „__ . Lc-benamg lop u it rV i 184 Ofii 1 1 r PrnHinn Rnt A.1 ^ «E' 14994 833 1 ! Lo Bending Bot 4355ft J • i Company Designer Job Number Plump Engineering, Inc Richard Plump 080337 The Forum of Carlsbad Mar 26, 2008 234PM Checked By _ Member Section Forces (By Combination) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 3? 33 34 35 36 37 38 39 40 LC 1 1 1 1 2 2 2 2 Member Label M1 M2 M3 M4 M1 M2 M3 M4 Sec 1 2 3 4 5 1 2 3 4 ^ 5 1 V 2 3 - 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 , 1 ( 7 s 3 4 5 1 2 3 4 5 Axialfkl 0 12 131 12 131 12131 -10647 -23011 -23011 -23011 ^-23&f&r- -23011 ^ . -2301iy -23011 . -23011 -23 01 1 -23011 6535 6535 6 '535 6535 6535 0 9865 9865 9865 -8659 -18714 -18714 -18714 -18^14 ^187T$N>v -18 714 -^ ^-JfLZl^ -18714 -18714 -18714 5314 5314 5314 5314 5314 v Shear[k] -765 5807 -726 -747 12 0 0 0- — °v ^ofv 0 0 r~ o - 0 0 0 0 0 0 0 -3978 2043 -1 354 588 624 0 0 \0 --^6 b^rti o\ \i o\ , Q\ -/ 0 \ 0 I _ 0 \ 0 \ 0 ^ 0 0 _z Shear'k] 0 0 0 0 0 0 : 0 0 0 . VTV0" ' To\, -/— >o\ tC:_LQ\A_> 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ^-^Q/^ (rvNkJvA --, 0 ^ 1^0 C 0 *-- 0 \ . no U M) ^_— -<r 0 0 Torquefk-ftl 0 o 0 0 0 0 0 0 0 0 0 -» \o \-i._Go^.)- 0 0 0 0 0 0 0 0 0 0 0 0 0 0 n 0 , Ao/\\) , no\ ^ ^VB^t ' tjO ^ Tfr^ VloJ _H — 0 0 0 0 y-y Momentfk-... Q ! 0 0 0 0 0 0 0 0 0 0 0 - 0 o 0 0 0 0 0 0 0 0 0 0 0 0 0 .0 V)b b o\ 0\ •• °\0 \ 0 \ ' — tf 0 0 0 z-z Momentfk- 0 i 21 154 -6506 -18632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15774 12027 -323 0 0 0 0 0 001 001 0 I 0 0 o i 0 ! o I 0 I 0 0 RISA-3D Version 702 [P \RISA3D\080337 r3d]Page 1 Plump Engineenng, Inc 914 E KatellaAve Anaheim, CA 92805 714-385-1835 FAX 714-385-1834 RichardPlump @ Peica com it'l'P ilt «:tN,U UC Split Ring Connection P= 24 kips Angle 68 deg Number of Plates Adjustment Factors Total Tension 1 25 1 1 1 1 11 Cd= Cm= Ct= Cg= Cdelta= Cst= NDS Table 10 2B Parallel Perpendicular Hankmson Formula Fallowable= Fallowable= 4360 00 Ib 3040 00 Ib 410959 Ib 5702 06 Ib Quantity of Rings Per Side N= 2 10 USE (4) 4 <D Split Rings per Side Thrust Plate b d S M fb Fy Fb Unity 4 in 1 75 in 2042 in' 12 k-i 5878 ks 36 ks 23 76 ks 0 247 < USE1 3/4 plate x 4 Side Plates I Area = Fv T allow = Welds T allow = 12 kips/plate 03^5 in 7 ,'5 in 27I9 144 ksi 39 15 > 12 kips 4 65 kips per inch of 5/16" weld T actual = 0 83 kips per inch T allow > T actual USE 3/8 side plates w/ 5/16" fillet weld each side Check A License Contractor's License Detail Page 1 of2 Skip to CSI..E Home | Content | Footer | Accessibility | ,Searcl'L • Department of Consumer Affairs ---•• ,•-:>. ^ iGOV Contractors State License Board 1^^^^^^^^^^^^^^^^^^^^^^^&^^^^^\jllliifi|illfllii!fiiilllifliil[ lillifTnflllii nTlillTTlilili iflilfilililTllllflliimliiill j 01 I j 02 I 03 I 04 I 05 I 06 ! I rnuttiwcD* I rnMTDArTnc*: ADD; irtur^ tniiPurvwCH cum ir wnnv-Q null mttn A^ciriLi c I 02 „ . | COHTRACTORS APPLtCAMIS UU I BUILDING OFFICIALS 07 GENERAL INFO AboutCSLB CSLB Newsroom Board and Committee Meetings Disaster Information Center CSLB Library Frequently Asked Questions Online Services c Check A License or HIS Registration o Fiiincj a Construction Complaint o Processing Tunes o Check Application SUiUi;- o Search fora Suiely Hond Insurance Company o Search for a Workers Compensalion Company How to Participate /•A 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 309472 Extract Date 04/10/21 SPS INC 3000 E MIRALOMA AVENUE ANAHEIM CA9.>806 Business Phone Number (714) 632 8333 Corporation 08/28/1975 04/30/2009 This license is current and active All information below should b> reviewed GENERAL BUILDING CONTRACTOR This license filed Contractors Bond number 942926C in the amou $12,500 with the bonding company INDEMNITY COMPANY OF CALIFORNIA Effective Date 01/01/2007 Contractors Bonding History 1 The Responsible Managing Officer (RMO) TERRY THOMAS PEIFFER certified that he/she owns 10 percenter more of th( voting stock/equity of the corporation A bond of qualifying individual is not required Effective Date 04/29/1992 http //www2 cslb ca gov/General-Infonnation/mteractive-tools/chec k-a-hcense/License+ 04/10/2008 Check A License Contractor's License Detail Page 2 of2 Workers This license has workers compensation insurance with the Compensation LINCQ.L.N.GENERAL,INSU RANCE COMPANY Policy Number CWC00002300 Effective Date 07/01/2007 Expire Date 07/01/2008 Workers Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses Consumers | Contractors | Applicants | Journeymen | Public Works | Building Officials | General Info CSLB Home j Conditions of Use | Privacy | Contact CSLB Copyright © 2007 State of California http //www2 cslb ca gov/General-Information/mteractive-tools/check-a-license/License+ 04/10/2008 Chent# 14688 SPSINC ACORD,, CERTIFICATE OF LIABI PRODUCER Armstrong/Robitaille Full 1010 680 Langsdorf Drive #100 PO Box 34009 Fullerton, CA 92834-9409 INSURED SPS Inc 3000 East Miraloma Ave Anaheim, CA 92806 LITY INSURANCE DATE (MM/DD/YYYY) 07/05/07 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 Lincoln General Insurance Co INSURER B INSURER C INSURER D INSURER E NAIC* 33855 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 1 HE POLICY PERIOD INDICATED NOTWITHSTANDING 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 INSR LTR A ADD'L NSRC TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | | OCCUR GEN L AGGREGATE LIMIT APPLIES PER | POLICY 1 1 JECT 1 1 L°C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY | OCCUR 1 J CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below OTHER POLICY NUMBER CWC00002300 POLICY EFFECTIVE DATE (MM/DD/YY) 07/01/07 POLICY EXPIRATION DATE (MM/DD/YY) 07/01/08 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG 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 X I WCSTATU I TORY I |MITS OTH ER EL EACH ACCIDENT EL DISEASE EA EMPLOYEE EL DISEASE POLICY LIMIT S $ s $ s s s $ $ $ s s s $ $ $ $ $ $1,000,000 s1, 000,000 $1,000,000 RE License Number 309472 CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non Payment of Premium Contractors State License Board PO Box 26000 Sacramento, CA 95826 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICA1 E HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE /ft**-' &JI/&&J ACORD 25 (2001/08) 1 of 2 #3394134/M394123 NMDAV ° ACORD CORPORATION 1988 o H C/1 8 pT-*™- _,. , «—.-*««,.._, „ V"™"^T^fj «**&"Q - -r-.?~r~-?** i.^.^1 r>CC" 'J ^.*>>-}"^1—r ^'-^' - - rr-«r u -.- ,r;j u D M °-•-I %Av CD Hn 01 -J > 11•o n•a 2 s ?= i § 1 an I § no •o. B" i? \ 1 \ & 0