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Home My WebLink About1929 PALOMAR OAKS WAY; ; CB150093; Permit03-09-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CB150093 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC #: Project Title: 1929 PALOMAR OAKS WY CBAD POOL 2130910600 Lot#: $19,520.00 Construction Type: FAIRFILED INN: 400 SF POOL 5B Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01/12/2015 JMA 03/09/2015 03/09/2015 Applicant: STEPHANIE ELLISON Owner: SURYA L P 10660 SCRIPPS RANCH BLVD #100 SAN DIEGO CA 92131 949-683-9862 Building Permit $202.39 Add'l Building Permit Fee $0.00 Plan Check $141.67 Add'l Plan Check Fee $0.00 Electrical Fee $33.00 Plumbing Fee $33.00 Strong Motion Fee $2.54 Green Bldg Standards (SB1473) Fee $1.00 Renewal Fee $0.00 Add'l Renewal Fee $0.00 Other Building Fee $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $413.60 Total Fees: $413.60 Total Payments To Date: $413.60 Balance Due: $0.00 Inspecto FINAL APPROVAL Date: 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 66C20(a), and file the protest and any other required information with the City Manager for processing in accordance with Carisbad Municipal Code Section 3.32.030. Failure to timely foliow 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/exactinns of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenwise expired. 03-09-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW150018 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: 1929 PALOMAR OAKS WY CBAD SWPPP 2130910600 CB150093 FAIRFILED INN: 400 SF POOL Applicant: STEPHANIE ELLISON 949-683-9862 Emergency Contact: DELL BAILEY 714-578-5760 Status: Lot#: 0 Applied: Entered By: Issued: Inspect Area: Tier: Priority: Owner: SURYA L P 10660 SCRIPPS RANCH BLVD #100 SAN DIEGO CA 92131 ISSUED 01/12/2015 JMA 03/09/2015 1 M SWPPP Plan Check SWPPP Inspections Additional Fees $53.00 $224.00 $0.00 TOTAL PERMIT FEES $277.00 Total Fees: $277.00 Total Payments To Date: $277.00 Balance Due: $0.00 FINAL APPROVAL DATE SIGNATURE THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: QfuNNING B^NGINEERING nBUILDING H^IRT •HEALTH • HAZMAT/APCD Ccityof Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buildlng@carlsbadca.gov www.carlsbadca.gov Plan Check No. Q3>\ "(f QQ EstValue W (^^SZO Plan Ck. Deposit Date \ f (2H jswPPP [S. \t SUITE#/SPACE#/UNrr* APN CT/PF*0JECT # L0T# PHASE* # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feetof Affected Area(s) ftx>u ^t^D Cs*^c£^^ {o&L^ £>eac EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESQ# Nl AIR CONDITIONING YES I INO I I FIRESPRINKLERS VESQ N0| I APPUCANT NAME Prtnarv Contact PROPERTY OWNER NAME ADDRESS ADDRESS STATE ZIP CITY PHONE EMAIL EMAIL DESISN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY , STATE _ ZIP . EMAI? FAX PHONE- - -j^ .-I / STATE Lie. # ^ _ t tn'mns CITY BUS. UC.# J /I uarfcef also requires the (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to'construct, alter, improve, demolish or repair any structura, prior to its issuaricef also requires the applicant for such permit to file a siened statement that he is licensed pursuant to the provisions ofthe Contractor's License Law (Chapter 9, commeriding v»ith Section 7000 of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500}). ^RfCE iS'i^ CO MP E NSAT I O N Workers' Compensation Declaration: / hereby affirni under penalty of perjury one of the followng declarations: • I have and will maintain a ceitificatB of consent to self-insure for worliers' compensation as proyided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. [St'have and wlll mainlain workers' compensation, as required by Sectio^7Q!i of )(ie Laborfode, for the performance of the work for which this permit is issued. My wori(ers' compensation insurance earner and policy numberare: InsuranceCo yAl^U^H^ /AJO- 1 C ^ Poiicv No. ^7<^ *fC'C03-1 Y Expiration Date - " ' S" This sedion need not be completed if the pemiit is for one hundred doiiars ($100) or less. I I Certificate of Exemption: i certify that in the perfonnance of the work for which this pemiit is issued, 1 shaii not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to secure worftere^omaetnatlon coverage is unlawful, and shali subject an employerto criminal penalties and chfil fines up to one hundred thousand doiiars (&100,000), in addition to the cost of compensation, dam^e^s^oyded for in Section 3706 of the Labor code, interest and attomey's fees. CONTRACTOR SIGNATURE OWNER-BUILOER DECtARATiON AGENT DATE / /lereby affirm that I am exempt fmm Contractor's License Law for Ihe following reason: I I 1, as owner of the property or my empioyees with wages as their sole compensation, wili 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). I I I, as owner of the property, am exclusively contracting with licensed contractors to constaict the project (Sec. 7044, Business and Professions Code: Ttie 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 Ucense Law). I I I am exempt under Section Business and Professions Code fbr this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. ^]Yes I |No 2.1 (have / have not) signed an application for a building pemiit for the proposed work. 3.1 have contracted with the following person (fimi) to provide the praposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the wort(, bul I have hired the following person to coordinate, supereise and provide the major worti (include name / address / phone / contractors' license number): 5.1 will provide some of the wori<, but 1 have contracted (hired) the following persons to provide the wori( indicated (include name / address / phone / type of wori<): ^PROPERTY OWNER SIGNATURE •AGENT DATE :;XOi»:|»«T'* TMIXaSEC.TION FOR N -« E S-l O S N Tg A ti: B WJ t P^l N 6 PERAftlTS ONtY Is the applicant or future building occupant required to submit a busineffiplant'acutely hazardous materials registration form or risk management and prevention program under Sections 26505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? • Yes ^fiCiiP Is the applicant or future building occupant required to obtain a pennit fron/he air pollution control district or^irquirilty management district? • Yes Is the facility to be constracted within 1,000 feet of the outer boundary of a school site? • Yes jSlNo IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEEflNG THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT CONSTi?UCTiON LENOING AGENCV 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 APPtlCANT CERTIFICATION 1 ceiti^ that I have lead the application and statethatthe above infonnatkm is conedand thatthe infbmiation on t^^ I hereby authorize representative of the City of Cartsbad 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 UABlLfnES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA pennit is required for excavalkxis EXPIRATION: Evety pemiit issued by the Buikling 180 days from the date of such pemiit or if the buil APPLICANT'S SIGNATURE er 5'0' deep and den^ilitkin or constructbn of stmctures over 3 stories in height. al under the pmviskins of this Code shall expiie by limitatkin and become null and void if the buikling or wori< authorized by such pemiit s not commenced within J by such pemiit is suspended a abandoned at any time alter the wort( is commenced for a period of 180 days (Sectfon 106.4.4 Unifomi Buikiing Code). DATE Inspection List Permit*: CB150093 Type: POOL FAIRFILED INN: 400 SF POOL Date Inspection Item Inspector Act Comments 06/10/2015 55 Fence/Pre-Plaster -Rl AM PLEASE 06/10/2015 55 Fence/Pre-Plaster PB AP 06/10/2015 59 Final Pool -Rl AM PLEASE 06/10/2015 59 Final Pool PB AP 04/13/2015 51 Excav/Steel/Bonding/Fence PB AP 04/10/2015 51 Excav/Steel/Bonding/Fence PD NR 03/12/2015 21 Underground/Under Floor PB AP 03/12/2015 23 Gas/T est/Repairs PB AP 03/12/2015 31 Underground/Conduit-Wlrin PB AP 03/12/2015 51 Excav/Steel/Bonding/Fence PB AP Friday, June 12, 2015 Page 1 of 1 ^ CiTY OF PLAN CHECK Community & Economic ^ CiTY OF REVIEW Development Department 1635 FaradayAvenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 01-21-2015 PROJECT NAME: FAIRFIELD INN & SUITES POOL/DECK PLANCHECKNO: 1 SET#: ADDRESS: 1929 PALOMAR OAKS WAY VALUATION/SCOPE OF WORK: $19,520 PROJECT ID: CB15 0093 APN: This plan check review is complete and has been APPROVED by the ENGINEERING Division. By: CG 1/21/15 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: DPSPERIVIITS@COX.NET You may also have corrections from one or more ofthe divisions Iisted below. Approval from these divisions may be required prior to the issuance ofa 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 760^02-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 760-602-4665 Chris.Sexton@carlsbadca.gov / Chris Glassen 760-602-2784 Chrlstopher.Glassen@carlsbadca.gov Gregorv.Rvan@carlsbadca.gov Gina.Ruiz@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Cynthia.Wong@carlsbadca.gov Dominic.Fieri@carlsbadca.gov Remarks: Any outstanding issues ivill lw marked ivilh an I X I Make the necessary corrections for compliance ivith applicable codes and standards. Siihinit corrected plans and/or specificatioiis lo the Buihling division for re-suhiiiitlal to lhe Engineering divisions. Items that conform to pennit rerpiirements are marked ivith | ^ | 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. MAP NO. REF. NO. 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. FOR POOL INSTALLATION SEE DWG#476-2A 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 rough qradinq approval obtained priorto Issuance ofa building permit. A separate grading plan prepared a registered civii engineer must be submitted together with the completed application form attached. No grading permit required. 3. MISCELLANEOUS PERMITS N/A 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 right-of-way checklist, at the time of resubmittal. Right-of-way permit and pool permit will be issued simultaneously. E-37 Page 3 of 4 REV 6/2012 4. STORMWATER Construction Compliance ^ Project Threat Assessment Form complete / incomplete / Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW is-oois ) 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.Ddf 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 COMMENTS E-37 Page 4 of 4 REV 6/2012 ^ CITY CARLSBAD O F STORM WATER COMPLIANCE ASSESSMENT B-24 Development Services Building Division 1635 FaradayAvenue 760-602-2719 www.carlsbadca.gov I am applying to the City of Carlsbad for the following type(s) of construction permit: •T^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 Alann Fixed Systems Mechanical Mobile Home Plumbing Patio/Deck 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 from tiie requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the "no tiireat" assessment criteria on the City's Project Threat Assessment Wori(sheet for Determination of Construction SWPPP Tier Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. Tier 1 - Low Ttireat Assessment Criteria la My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt pemiit type (See list above) and the project meets one or more of the foilowing criteria: • Results in some soil disturbance; and/or 56 VP<2-PS C>f ^(i- ^^^f^yj A^iO\i • Includes outdoor construction activities (such as saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling). r/er 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 pursuant to the Carisbad Grading Ordinance (Chapter 15.16 of the Carlsbad 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 orwill extend into the rainy season (Oct. 1 through April 30). Tier 3 - Significant Threat Assessment Criteria • My project includes clearing, grading or other disturbances to the ground 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 development 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 nearby receiving waters by way of storm water runoff or non-storm water 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 ofa 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 Citv Standards. 'The City Engineer may authorize minor variances from the Storm Water Threat Assessment Criteria in special circumstances where it can be shown that a lesser or tiigher Constmction SWPPP Tier Level is waranted. ProjectAddress: Assessor Parcel No. Owner/Owner's Authorized Agent Name: Title: Ovmer/Ownsfs AultibrEBd Agent Signature: K^^.^^A^^^'^Jh-^ Date: ^ city Concurrence: By: Date: (|5YES QNO Cfe- \-Xia'\^ ProjectID: 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 Tier 3 Tier 3 - Hioh Construction Threat Assessment Criteria High Tier 3 • 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 Tier 3 Tier 3 - Medium Construction Threat Assessment Criteria Medium Tier 3 • All projects not meeting Tier 3 High Construction Threat Assessment Criteria Medium Tier 2 Tier 2 Hioh Constnjction 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 tiighly erosive (defined as tiaving 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 Medium Tierl • Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, within or directly adjacent to an environmentally sensitive area (ESA) or disctiarges directly to an ESA • Soil at site is moderately to highly erosive (defined as tiaving 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 Hr Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 througti 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 construction 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 STORM WATER Development Services Land Development Engineering STANDARDS Development Services Land Development Engineering CITY OF QUESTIONNAIRE E-34 1635 Faraday Avenue 760-602-2750 CARLSBAD 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.carlsbadca.aov/standards. Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or constmction permits). The results of the questionnaire determine the level of stonn 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 Stormwater Requirements' or be subject to additional criteria called 'Priority Development Project Requirements'. Many aspects of project site design are dependent upon the storm water standards applied to a project. Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire was incorrectly filled out and is subject to more stringent 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 ttie ctianges to the questionnaire and resubmit to the City. If you are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, please seek assistance from Land Development Engineering staff. A separate completed and signed questionnaire must be submitted for each new development application submission. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently. In addition to this questionnaire, you must also complete, sign and submit a Project Threat Assessment Form with construction permits for the project. Please start by completing Step 1 and follow the instructions. When completed, sign the form at the end and submit this with your application to the city. STEPI TO BE COMPLETED FOR ALL PROJECTS 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 ttiat 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 tiydraulicaily disconnected from paved streets or roads; OR (3) designed and constructed with permeable pavements or surfaces in accordance with USEPA Green Streets guidance? X 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? K If you answered "yes" to one or more of ttie above questions, ttien your project is NOT a priority development project and ttierefore is NOT subject to the storm water criteria required for priority development projects. Go to step 4, mark the last box stating "my project does not meet PDP requirements" and complete applicant information. 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 STEP 2 1 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? This 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. K 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 partying 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. K 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, higtiway freeway or driveway? A street, road, highway, freeway or driveway is any paved impen/ious surface used for the transportation of automobiles, trucks, motorcycles, and other vehicles. K 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 overiand 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. 10.1s your project a new or redevelopment project that results in ttie disturbance of one or more acres of land and are expected to generate pollutants post construction? 11.1s your project located wittiin 200 feet of ttie 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 Stomn 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 Storm Water Management Plan (SWMP) is not required with your application(s) for development. Go to step 4 at the end of this questionnaire, check the "my project does not meet PDP requirements" box and complete applicant information. E-34 Page 2 of 3 Effective 6/27/13 ^5^^ CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov TO BE COMPLETEO FOR REDEVELORMENT PROJECTS THAT ARE PRIORITT DEVELOPEMENT PROJECTS ONLY Complete the questions below regarding your redevelopment project: YES NO Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than 50% of the surface area of ttie 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. CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT INFORMATION My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stonnwater criteria per the SUSMP and I understand I must prepare a Storm Water Management Plan for submittal at time of application. I understand flow control (hydromodification) requirements may apply to my project. Refer to SUSMP for details. My project does not meet PDP requirements and must only comply with STANDARD STORMWATER REQUIREMENTS per the SUSMP. As part ofthese requirements, I will incorporate low impact development strategies throughout my projecL Applicant Information and Signature Box ApplicantName: Accessor's Parcel Number(s): Applicant Title: Applicant Signature: Date: This Box for City Use Only City Concurrence: YES NO City Concurrence: A By: CG- Date: , . ^ ~iS Project ID: ^ g 15-^3 * Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their quivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent environmentally sensitive areas which have been identified by the Copermittees. E-34 Page 3 of 3 Effective 6/27/13 CARLSBAD CITY OF 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 storm water mnoff or non-storm water discharge(s). <^ My project does not require a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 ofthe Carisbad Municipal Code) • My project will not result In 2,500 square feet or more of soils disturtDance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas that meets one or more of the 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 • disturiDed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse; and/or • construction vi/lll t>e 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. I 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. 1 0WNER(S)/0WNER;S AGENT NAME (PRINT) ^•£fj<^yy^ ER(S)/OWNER'S AGENT NAME (SIGNATURE) DATE 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 F?AIN PROBABILITY FORECAST EXCEEDS FORTY PERCENT (40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 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 PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. SPECIAL NOTES PROJECT INFORMATION Site Address 41-UKIVIAIIUN Assessor's Parcel Number: 3^ LS-CKDX%' Project ID: Construction Permit No.: Estimated Constmction Start Date Project Duration Months Emergency Contact: Name:5^iL_&lj_L 24 hour Phone: Perceived Threat to Storm Water Quality Medium Low If medium box Is checked, must attach a site plan sheet showing proposed work area and location of proposed structural BMPs For City Use Only Approved By: CITY OF CARLSBAD STANDARD TIER 1 SWPPP Date: 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 Earih Dikes and Drainage Swales Slope Drains Silt Fence Sediment Trap Check Dam Fiber Rolls Gravel Bag Berni 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 Manaaement Hazardous Waste Manaaement Concrete Waste Manaaement CASQA Designation -> Construction Activity EC-7 EC-8 EC-9 EC-11 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 V, WM-2 WM-3 WM-4 WM-5 WM-6 WM-8 Grading/Soil Disturbance / V Trenching/Excavation Stcx:kpiling w / / y / Drilling/Boring Concrete/Asphalt Saw cutting Concrete flatworic Paving Conduit/Pipe Installation Stucco/Mortar Wori< Waste Disposal Staging/Lay Down Area v' Equipment Maintenance and Fueling Hazardous Substance Use/Storage Dewatering Site Access Across Dirt Other (list): Instructions: Begin by reviewing the list of cxjnstruction activities and checking the box to the left of any activity that will cx;cur during the proposed construction. Add any other activity descriptions in the blank activity description boxes provided for that purpose and place a check in the box immediately to the left of the added activity description. For each activity descrribed, pick one or more best management practices (BMPs) from the list located along the top ofthe 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 eacti 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 Construction Ingress/Egress" under Tracking Control. Follow along the "Site Access Across Dirt" row until you get to the "Stabilized Construction Ingress/Egress" column and place an X in the box where 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 IDOX where the "Stockpiling" row intersects the new "Cover with Plastic" column. To learn 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 California Stormwater Quality Association (CASQA) designation and how to apply the various selected BMPs to a project. E-29 Page 2 of 3 REV 4730/10 CITY OF CARLSBAD PLANNING DIVISION BUILDING PLAN CHECK APPROVAL P-29 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carl.sbadca.sov DATE: 1/12/2015 PROJECT NAIVIE: Fairfield Inn PROJECT ID: CUP 11-06 PLAN CHECK NO: CB150093 SET#: 1 ADDRESS: 19 APN: 213-091-06 3 This plan check review is complete and has been APPROVED by the Planning Division. By: Austin Silva A Final Inspection by the Planning Division is required • Yes ^ No You may also have corrections from one or more of the divisions Usted below. Approval from these divisions may be required prior to the issuance ofa building permit. Resubmitted plans should include corrections from all divisions. • This plan check review is NOT COIVIPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL has been sent to: dpspermits@cox.net 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 1 1 Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov 1 1 Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov Q Greg Ryan 760-602-4663 G regory. Rya n@ca risbadca .gov 1 1 Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov 1 1 Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov 1 1 Cindy Wong 760-602-4662 Cvnthia.Wong@carlsbadca.gov X Austin Silva 760-602-4631 Austin.silva@carlsbadca.gov • Dominic Fieri 760-602-4664 Dominlc.Fieri@carlsbadca.gov Remarks: REAR SETBACK LINE- REQUIRED LANDSCAPE