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HomeMy WebLinkAbout2491 WELLSPRING ST; ; CB160771; PermitPrint Date: 01/23/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: #Dwelling Units: Bedrooms: Project Title: 2491 Wellspring St BLDG-&liiiiii€ici:Jt" ~ 2081929100 $27,842.00 City of Carlsbad 1635 Faraday fw Carlsbad, CA 92008 e.e.s 1 d.el\. -h tv\ .Cenllnercial Permit www.carlsbadca.gov Work Class: Pool Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Description: POOL-RANCHO COSTERA:540 SF POOL/SPA Total Fees: Total Payments To Date: Status: Applied: Issued: Finaled: Inspector: Contractor: PRP AQUATICS INC 5748 Avenida Robles Granite Bay, CA 95746-7901 916-743-2290 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Permit No: CB160771 Issued -Active 02/26/2016 03/28/2016 PBurn :FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING 0BUILDING OFIRE (_City of Carlsbad JOB ADDRESS CT/PROJECT # EXISTING USE APPLICANT NAME Primary Contact ADDRESS DESIGN PROFESSIONA ADDRESS CITY \ v \\ (j PHONE EMAIL Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITE#/SPACE#/UNIT# #BATHROOMS GARAGE (SF) PATIOS (SF) DECKS (SF) ZIP STATE LIC. # STATE L1C.#-.J Est. Value Plan Ck. Deposit CITY BUS. LIC.# (Sec. 7031.5 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 Contractor's 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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). ~"~~-~~~r C ~ 0 ~--· ~~~,.-~-~~ ~-~~;;~~-~-~-?~y~O"~--~_,.-C,, ···~ '"~="~~~~~· '';-~~-·--~~-·~·-r•~-~""'1\l ~WORKERS' COM~ENSATION. · -·: · ~ ·. · . :·.o;o.::.:~· ...... -' .<· : •.~· .. /-..; ·· :oil ;;.,... -~ ~=~ ~~ ~M --~~ ~ ·-~~ =~;.;:.;..W~~ ·~~ -··~ ~ ~"~~~~="""'"""~~=·==·~""""~'::.~~:-_,_ .. M:..~.~~~""""'-~~~~--=;,;J~~"'"'"""~~~~ ... :;_~=""""~~;..;_o;;L_=~~:~~~ill""-·-.;;..;;~-~~~ ~~-"·~~~--"' -~.,.);, Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a 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. 0 I have and will maintain workers' com-pensation, as required by sect_ ion 3_700 of the Labor Code: for the_ performan~-~\f .the work for which_ this fljlim .. it,is issued.. My workers' compensationliiS'ura~ 'er\and policy h I , ..M ) , !'f I 1...-Jh.d\. t : I l , . vl•; " -\ t \ V· : (\ r, c/.r.<"' ''--4..•. '/ --t-" ~ ,~ number are: Insurance Co. !~ [/!;3,! t' \' \Vv'l, l:"'ll"-1') 1 ~ 1/\.1 ,I I ,policy No. . V / l /.' 1.: 1;..~ J<' 1/ Expiration Date 'J C~ · This section need nol be compleled ff the permit is for one hundred dollars [$1 00) or less. j 0 Certificate of Exemption: I certify lhat 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 doUars (&100,000], in addition to the cost of compensation, damages as ~rdvided for in Section 3706 of th'e·t-apo;tode, interest and attorney's fees. ~\ ~ \ \ \U . ' \ \ \I -' 2:f CONTRACTOR SIGNATURE \ \· t\ ;\_ kA ; ' \ 'EJAGENT DATE ~ " \ l /; I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D D D 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 Contracto(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 lhat such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, lhe owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contraclors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(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 Contracto(s License Law). 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. DYes 0No 2. I [have I have nol) signed an application for a building permit for lhe proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide lhe major work (include name I address I phone I contractors' license number): 5. I will provide some of lhe work, bull have contracted (hired) the following persons to provide the work indicated (include name I address I phone I type of work): 2:f PROPERTY OWNER SIGNATURE 0AGENT DATE 1 certify that 1 have read the application and state that the above information is conect and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize represenlative of the City of Carlsbad to enter upon the above mentioned property fur 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: M OSHA permtt is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permtt issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ff the buik:ling or mrk authorized by such permit is not commenced V>ithin 180 days from the date of such permit or if the building ormrk authorized by such permit is at any time after the mrk is commenced for a of 180 (Section 106.4.4 Uniform Building Code). Ji5 APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OIF OCCUPANCY I Commercial Projects 0 n ly 1 Fax {760) 602-8560, Email building@carlsbadca.govor Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS D PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o ASSOCIATED CB# D MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION D MAIL/ FAX TO OTHER: o CHANGE OF USE/ NO CONSTRUCTION ~APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB160771 Type: POOL RANCHO COSTERA:540 SF POOUSPA Date .... _!I!..S.P_ection.ltem Inspector Act Comments --··---··-----· 04/29/2016 55 Fence/Pre-Piaster PB AP 04/29/2016 59 Final Pool PB AP 04/26/2016 55 Fence/Pre-Plaster PB NR 04/19/2016 51 Excav/Steei/Bonding/Fence PB AP 04/15/2016 66 Grout PB PA 04/07/2016 66 Grout PB PA 03/30/2016 23 Gas/Test/Repairs PB AP 03/29/2016 31 Underground/Conduit-Wirin PB AP 03/29/2016 51 Excav/Steei/Bonding/Fence PB AP 03/29/2016 52 Underground Plumbing PB AP Friday, January 20, 2017 Page 1 of 1 • ~~~) ~ CITY OF CARLSBAD PLAN CHECK REVIEW TRANSMITTAL DATE: 03-03-2016 PROJECT NAME: ROBERTSON RANCH POOL/SPA PLAN CHECK NO: SET#: 1 ADDRESS: 2491 WELLSPRING ST. VALUATION/SCOPE OF WORK: $27,842 Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carlsbadca.gov PROJECT ID: CB16-0771 APN: 208-192-91-00 This plan check review is complete and has been APPROVED by the ENGINEERING Division. By: CG 3/3/16 A Final Inspection by the Division is required Yes .f No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. NOTE: ONLY ITEMS THAT NEED CORRECTION/CLARIFICATION ARE MARKED X. Plan Check Comments have been sent to: CARRIEJONES@HOTMAIL.COM You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the ISsuance·of a bUilding permit Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov Remarks: Chris Glassen 760-602-2784 Christopher .Giassen@ca rlsbadca.gov Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov Greg Ryan 760-602-4663 Gregory.Ryan@carlsbadca.gov Cindy Wong 760-602-4662 Cynthia.Wong@carlsbadca.gov Dominic Fieri 7 60-602-4664 Dominic.Fieri@carlsbadca.gov E-37 Any outstanding issues will be marked with an [X] Make the necessary corrections for compliance with applicable codes and standards. Submit corrected plans and/or specifications to the Building division for re-submittal to the Engineering divisions. Items that confonn to permit requirements are marked with [{] 1. SITE PLAN Provide a fully dimensioned site plan drawn to scale. Show: 1 North arrow Existing & proposed structures · Property line dimensions Easements Show on site plan: Drainage patterns Existing & proposed slopes 1 Existing topography Retaining Walls (location and height) Indicate what will happen with soil excavated from pool area. lncluae on title sheet: f{J Site address Assessor's parcel number Legal description/lot number Grading: Quantities of Cut Fill Import Project does not comply with the following engineering conditions of approval for project no: Conditions were complies with by: LOT NO. 207 MAP NO. 16091 REF. NO. CT 13-03 Page 2 of 4 Date: REV 6/2012 1 2. GRADING PERMIT REQUIREMENTS The conditions that require a grading permit are found in Section 11.06.030 of the Municipal Code. Inadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This infonnation 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 grading approval obtained prior to issuance of a building permit. A separate grading plan prepared a registered civil engineer must be submitted together with the completed application form attached. ·• ;:; i No grading permit required. 3. MISCELLANEOUS PERMITS NO R.O.W. RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work PERMIT PER adjacent to the public right-of-way. PLANS E-37 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. Page 3 of 4 REV 6/2012 E-37 1 4. STORM WATER Construction Compliance Project Threat Assessment Form complete[{] incomplete ......... ,. Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW 16-105 ) 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 [{.1 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:/lwww.carlsbadca.gov/business/buildinq/Documents/EngStandsw-stds-vol4-ch2.pdf · Project needs to incorporate low impact development strategies throughout in one or more of the following ways: · Rainwater harvesting (rain barrels or cistern) Vegetated Roof Bio-retentions cell/rain garden Pervious pavement/pavers ; Flow-through planter/vegetated or rock drip line Vegetated swales or rock infiltration swales Downspouts disconnect and discharge over landscape ; Qther: 5. ADDITIONAL COMMENTS Page 4 of 4 REV 6/2012 (:City of Carlsbad DETERMINATION OF PROJECT'S SWPPP TIER LEVEL AND CONSTRUCTION THREAT LEVEL E-32 Development Services land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov I'm applying for: D Grading Permit Project N~e:. l.o~\ Address:~t L...l)eHP-f)rtt'\0/\~. D Right-of-way permit D Other \ \ Project ID: -:-7'""-.----=-r-DWG #/CB# --=,-(--=--- APN )b{)?i?i d =i1J Disturbed Area: _____.5"q~·-==o~_Ac Section 1: Determination of Project's SWPPP Tier Level (Check applicable criteria and circle the corresponding SWPPP Tier Level, then go to section 2) Exempt -No Threat Project Assessment Criteria My project is in a category of permit types exempt from City Construction SWPPP requirements. Provided no significant grading proposed, pursuant to Table1, section 3.2.2 of Storm Water Standards, the f.9._!!gYY.!E!9 .. P.~r.!:)}_!!:?. .. §~~--~-~~-!!.!P.! .. f.!:9..!!.! .. ~Y.YP..~.P. .. r.~9.!:!!E~.!!.!~~!.~~---·································-,-·-·····················································································; ) >-Electrical ) >-Patio ) >-Mobile Home ) >-Plumbing ) >-Spa (Factory-Made) [ t:::~:::::·Fi~~--s~-~i~k-~~~---·-r·;· .. --M~-~h-~~-i~~-~---·r;······R~=-R~~fi-~-9----·······-r;:···· .... si9·~--------·········t; .. ------R~~t=M·~~-~t~d--s-~i-~~-;;:~~~;····j Tier 3-Significant Threat Assessment Criteria-(See Construction General Permit (CGP) Section I. B)* 0 My project includes construction or demolition activity that results in a land disturbance of equal to or greater than one acre including but not limited to clearing, grading, grubbing or excavation; or, 0 My project includes construction activity that results in land disturbance of less than one acre but the construction activity is part of a larger common plan of development or the sale of one or more acres of disturbed land surface or, 0 My Project is associated with construction activity related to residential, commercial, or industrial development on lands currently used for agriculture; or 0 My project is associated with construction activity associated with Linear Underground/overhead Projects (LUP) including but not limited to those activities necessary for installation of underground and overhead linear facilities (e.g. conduits, substructures, pipelines, towers, poles, cables, wire, towers, poles, cables, wires, connectors, switching, regulating and transforming equipment and associated ancillary facilities) and include but not limited to underground utility mark out, potholing, concrete and asphalt cutting and removal, trenching, excavation, boring and drilling, access road, tower footings/foundation, pavement repair or replacement, stockpile/borrow locations. 0 Other per CGP Tier 2-Moderate Threat Assessment Criteria: My project does not meet any of the Significant Threat Assessment Criteria described above and meets one or more of the following criteria: 0 Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, 0 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 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 • disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through Apr. 30). Tier 1-Low Threat Assessment Criteria My project does not meet any of the Significant or Moderate Threat criteria above, is not an exempt ermit type per above and the project meets one or more of the following criteria: results in some soil disturbance; and/or • includes outdoor construction activities (such as roof framing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling) SWPPP Tier Level Exempt Tier3 Tier2 Tier 1 * Items listed are excerpt from CGP. CGP governs cntena for tnggers for T1er 3 SWPPP. Developer/owner shall conf1rrn coverage under the current CGP and any amendments, revisions and reissuance thereof. E-32 Page 1 of 2 Rev. 2/16/16 .. . SWPPP Section 2: Determination of Project's Construction Threat Level Tier (Check applicable criteria under the Tier Level as determined in section 1, circle Construction Level the corresponding Construction Threat Level, then complete the Threat Level signature block below) Exempt -Not Applicable -Exempt Tier 3-High Construction Threat Assessment Criteria: M}! Project meets one or more of the following: 0 Project site is 50 acres or more and grading will occur during the rainy season 0 Project site 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 High 0 Soil at site is moderately to highly erosive (defined as having a predominance of soils Tier3 with USDA-NRCS Erosion factors kf greater than or equal to 0.4) 0 Site slope is 5 to 1 or steeper 0 Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 -April 30). 0 Owner/contractor received a Storm Water Notice of Violation within past two years Tier 3-Medium Construction Threat Assessment Criteria Medium 0 All projects not meeting Tier 3 High Construction Threat Assessment Criteria Tier 2 -High Construction Threat Assessment Criteria: My Project meets one or more of the following: 0 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 0 Soil at site is moderately to highly erosive (defined as having a predominance of soils High with USDA-NRCS Erosion factors kt greater than or equal to 0.4) Tier2 0 Site slope is 5 to 1 or steeper 0 Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1-Apr. 30). 0 Owner/contractor received a Storm Water Notice of Violation within past two years 0 Site results in 10,000 sq. ft. or more of soil disturbance Tier 2-Medium Construction Threat Assessment Criteria Medium 0 My project does not meet Tier 2 High Threat Assessment Criteria listed above Tier 1 -Medium Construction Threat Assessment Criteria: My Project meets one or more of the following: 0 Owner/contractor received a Storm Water Notice of Violation within past two years Medium 0 Site results in 500 sq. ft. or more of soil disturbance Tier 1 0 Construction will be initiated during the rainy season or will extend into the rainy season (Oct.1-April 30) Tier 1 -Low Construction Threat Assessment Criteria Low 0 My project does not meet Tier 1 Medium Threat Assessment Criteria listed above I certify to the best of my knowledge that the above statements are true and correct. I Will prepare and submit an appropnate tier level SWPPP as determmed above prepared in accordance with the City SWPPP Manual. I understand and acknowledge that I must adhere to and comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards at all times during construction activities for the permit type(s) checked above. The City Engineer/Building Official may authorize minor variances from the Construction Threat Assessment Criteria in special circumstances where it can be shown that a lesser or higher SWPPP Tier Level is warranted. City Concurrence: Yes No (For City Use Only) By: Date: Project ID: E-32 Page 2 of2 Rev. 2/16/16 (City of Carlsbad STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov To address post-development pollutants that may be generated 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 Carlsbad BMP Design Manual (BMP Manual). To view the BMP Manual, refer to the Engineering Standards (Volume 5). This questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of storm water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'STANDARD PROJECT' requirements or be subject to 'PRIORITY DEVELOPMENT PROJECT' (PDP) requirements. 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 storm water standards than initially assessed by you, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City. If you are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, please seek assistance from Land Development Engineering staff. A completed and signed questionnaire must be submitted with each development project application. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently . • I ••.• )• ,, ' ••. :; .•.•. .. •.•• •.. • • .•. I .· .'': ; •• i ( ; i I. '... • I :•w,,;.;;/,;:,1:::;. ' ,,;~, [i't\~,;.~/·i ,,,,. •;;,. ;.. i.ii:e ~~~:J;§,J:;~,;I N f,Q,BM~ml ~~;~;e.~ti::ir;),;f; :ii4:.~i ·:,mli1lilii1i'•#? ~:!~:·~!1.;.;.: ;~!i ·• ,i:,x:.:i :'•,:: !;9.i\:'1ill~l.~:r::••J)Iii: ':• if~ll!iii Ui!i,~':• r::,:•'1 PROJECT NAME: PROJECT ID: The project is (check one): 0 New Development 0 Redevelopment The total proposed disturbed area is: ft2 ( ) acres The total proposed newly created and/or replaced impervious area is: ft2 ( ) acres If your project is covered by an approved SWQMP as part of a larger development project, provide the project ID and the SWQMP # of the larger development project: Project ID: ____________ SWQMP #: ----------- Then, go to Step 1 and follow the instructions. When completed, sign the form at the end and submit this with your application to the City. E-34 Page 1 of 4 REV 02/16 To determine if your project is a "development project", please answer the following question: Is your project LIMITED TO routine maintenance activity and/or mprovements to an existing building or structure that do not after the size (See Section 1.3 of the BMP Design Manual for guidance)? If you answered "yes" to the above question, provide justification below then Go to step 5, mark the third box stating "my project is not a 'development project' and not subject to the requirements of the BMP manual" and complete applicant information. Justification/discussion: (e.g. the project includes only interior remodels within an existing building): To determine if your project is exempt from PDP requirements pursuant to MS4 Permit Provision E.3.b.(3), please answer the following questions: Is your project LIMITED to one or more of the following: 1. Constructing new or retrofitting paved sidewalks, bicycle lanes or tra meet the following criteria: a) Designed and constructed to direct storm water runoff to adjacent vegetated areas, or other non- erodible permeable areas; b) Designed and constructed to be hydraulically disconnected from paved streets or roads; c) Designed and constructed with permeable pavements or surfaces in accordance with USEPA Green Streets guidance? 2. Retrofitting or redeveloping existing paved alleys, streets, or roads that are designed and constructed in accordance with the USEPA Green Streets guidance? 3. Ground n section 1.4.2 If you answered "yes" to one or more of the above questions, provide discussion/justification elow, then mark the second box stating "my project is EXEMPT from PDP ... " and complete applicant information. YES NO Discussion to justify exemption ( e.g. the project redeveloping existing road designed and constructed in accordance with the USEPA Green Street guidance): If you answered "no" to the above questions, your project is not exempt from PDP, go to Step 3. E-34 Page 2 of4 REV. 02/16 To determine if your project is a PDP, please answer the following questions (MS4 Permit Provision E.3.b.(1)): 1. Is your project a new development that creates 1 0, 000 square feet or more of impervious surfaces collectively over the entire project site? This includes commercial, industrial, residential, mixed-use, and de on or · land. 2. Is your project a redevelopment project creating and/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 nrr"""~t<> on or land. 3. Is your project a new or redevelopment project that creates and/or replaces 5, 000 square feet or more of impervious surface collectively over the entire project site and supports a restaurant? A restaurant is ~facility that sells prepared foods and drinks for consumption, including stationary lunch counters and' refreshment stands selling prepared foods and drinks for immediate consumption (Standard Industrial Classification code 581 . 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 d includes develo on a natural that is r. 5. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface collectively over the entire project site and supports a parking lot? A parking lot is a land area or facility for the temporary parking or storage of motor vehicles used personally for business or for commerce. 6. Is your proJect a new or redevelopment project that creates and/or replaces 5, 000 square or more of impervious surface collectively over the entire project site and supports a street, road, highway freeway or driveway? A street, road, highway, freeway or driveway is any paved impervious surface used for the of and other vehicles. 7. Is your project a new or redevelopment project that creates and/or replaces 2,500 square feet or more of impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive Area (ESA)? "Discharging Directly to" includes flow that is conveyed overland a distance of 200 feet or less from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the to the ESA not with flows from cent * 8. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface 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 codes: 501 5014 5541 7532-7534, or 7536-7539. 9. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious area 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 Traffic of 100 or more vehicles 10. Is your project a new or redevelopment project that results in the disturbance of one or more acres of land and are expected to generate pollutants post construction? 11. Is your project located within 200 feet of the Pacific Ocean and (1) creates 2,500 square feet or more of impervious surface or (2) increases impervious surface on the property by more than 10%? (CMC 21.203. YES If you an to one or more the above questions, your project is a . If your project is a redevelop project, Go to step 4. If your project is a new project, Go to step 5, check the first box stating "My project is a PDP ... " and complete applicant information. If you answered "no" to all of the above questions, your project is a 'STANDARD PROJECT', "Go to step 5, check the second box stati ·ect is a 'STANDARD PROJECT ... " and com licant information. E-34 Page 3 of4 REV. 02/16 ... YES NO rcrtc\l·ctrmment project result in the creation or replacement of impervious surface in an amount of less than 50% of the surface area of the previously existing development? Complete the percent impervious calculation below: Existing impervious area (A) = sq. ft. Total proposed newly created or replaced impervious area (B)= sq. ft. Percent impervious area created or replaced (B/A)*1 00 = % If you answered "yes", the structural BMP's required for PDP apply only to the creation or replacement of impervious surface and not the entire development. Go to step 5, check the first box stating "My project is a PDP ... " and complete applicant information. If you answered "no," the structural BMP's required for PDP apply to the entire development. Go to step 5, check the check the first box stating "My project is a PDP ... " and complete applicant information. D My project is a PDP and must comply with PDP stormwater requirements of the BMP Manual. I understand I must prepare a Storm Water Quality Management Plan (SWQMP) for submittal at time of application. 0 My project is a 'STANDARD PROJECT' OR EXEMPT from PDP and must only comply with 'STANDARD PROJECT' stormwater requirements of the BMP Manual. As part of these requirements, I will submit a "Standard Project Requirement Checklist Form E-36" and incorporate low impact development strategies throughout my project. Note: For projects that are close to meeting the PDP threshold, staff may require detailed impervious area calculations and ~xhibits to verify if 'STANDARD PROJECT' stormwater requirements apply. ~ ........ :.y Project is NOT a 'development project' and is not subject to the requirements of the BMP Manual. Applica~lnformation and Signature Box I ~ Assessor' ~arc I ~umbers · , V\A ) I /. I Applicant Title: Applicant Si9if'ature~ c Date: * 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 equivalent under the Multi Species Conservation Program within the Cities and County of San Diego; Habitat Management Plan; and any other equivalent environmentally sensitive areas which have been identified by the City. This Box for City Use Only City Concurrence: L YES l NO I I By: Date: Project ID: E-34 Page 4 of4 REV. 02/16 (City of Carlsbad STANDARD PROJECT REQUIREMENT CHECKLIST E-36 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov All development projects must implement source control BMPs SC-1 through SC-6 where applicable and feasible. See Chapter 4 and Appendix E.1 of the BMP Design Manual for information to implement source control BMPs shown in this checklist. Answer each category below pursuant to the following. · • "Yes" means the project will implement the source control BMP as described in Chapter 4 and/or Appendix E.1 of the Model BMP Design Manual. Discussion/justification is not required. • "No" means the BMP is applicable to the project but it is not feasible to implement. Discussion/justification must be provided. • "N/A" means the BMP is not applicable at the project site because the project does not include the feature that is addressed by the BMP (e.g., the project has no outdoor materials storage areas). Discussion/justification may be ·ded. SC-3 Protect 0 Runoff and Materials Storage Areas from Rainfall, Run-On, I Discussion/justification if SC-3 not implemented: in Outdoor Work Areas from Storage Areas , and Wind Discussion/justification if SC-5 not implemented: E-36 Page 1 of 3 0 N/A 0 N/A 0 N/A REV 02/16 :::~~;;::~~~~i~:i~~?!t1'~iJ~~~~m~~~~~;~~~;.JJ~:;j'.:;~\:i~~?i:~.·~.·.\~:~:;~::;,~S.'QU~~¢'e:{:J,CQ',ifl.tfQ'~~-Bi~·R':~;i.~~fiit6~~1Jiii~~~~~i~~~riJ~i~:~t1~·~!;;k:~~2i::·;:r\'\ ',,; : ,, :. : '~ " ; ~~~~~p""'f""'CJP'~' •... >·~''··· ":·.·I···~ .~~~ ... J •• P.l.e. ~·'b, .. ,~:i,' : ..... SC-6 Additional BMPs based on Potential Sources of Runoff Pollutants must answer for each source listed below and identify additional BMPs. (See Table in Appendix E.1 of BMP Manual for guidance). 0 On-site storm drain inlets o Yes o No ~/A D Interior floor drains and elevator shaft sump pumps DYes D No ~/A D Interior parking garages DYes D No d{N!A D Need for future indoor & structural pest control DYes D No OfN/A D Landscape/Outdoor Pesticide Use DYes ip--No D N/A D Pools, spas, ponds, decorative fountains, and other water features ~Yes D No D N/A D Food service DYes ~0 D N/A D Refuse areas 'fl Yes D No D N/A D Industrial processes DYes D No D N/A D Outdoor storage of equipment or materials ~lPYes D No D N/A D Vehicle and Equipment Cleaning DYes ~ D N/A D Vehicle/Equipment Repair and Maintenance DYes D N/A D Fuel Dispensing Areas DYes ~0 D N/A D Loading Docks DYes d'No D N/A D Fire Sprinkler Test Water DYes ttrNo D N/A D Miscellaneous Drain or Wash Water DYes ~No D N/A D Plazas, sidewalks, and parking lots DYes ~0 D N/A For "Yes" answers, identify the additional BMP per Appendix E.1. Provide justification for "No" answers. E-36 Page 2 of3 REV. 02/16 ... ;···,··.·,,,, •r .. ir,c·::;ii):•.,:;[~. '· >;:~,;;:, ,,.,::. b1 ::;,:.ii:~i:~~_::·:·::., . . ,;Sit~~[!).¢sigiJJ§Me$'~'::: ,;::,\,~li:',;,. ~~~~:: ::.:.~;a.:~( .. ,;, i,~,i:t'; .. .'<.: ''f' "':.:l.;1iM~·!!iffi~ All development projects must implement site design BMPs SD-1 through SD-8 where applicable and feasible. See Chapter 4 and Appendix E.2 thru E.6 of the BMP Design Manual for information to implement site design BMPs shown in this checklist. Answer each category below pursuant to the following. • "Yes" means the project will implement the site design BMPs as described in Chapter 4 and/or Appendix E.2 thru E.6 of the Model BMP Design Manual. Discussion I justification is not required. • "No" means the BMPs is applicable to the project but it is not feasible to implement. Discussion/justification must be provided. • "N/A" means the BMPs is not applicable at the project site because the project does not include the feature that is addressed by the BMPs (e.g., the project site has no existing natural areas to conserve). Discussion/justification may be provided. 1·· < " .·; .. ;c.::.···· ., ... · .:·.· ··<•'i':.: j;i:t•Sit~O~slgri,~R~Q.ui~~m·~Ht:,~.0;;r:>., .•... · ... · ~~~ ;:' ':·:·:1,~:: ···· '' •··· ..... ·.·• ··1' •• ·.,,,.;, :.:!,'•.'• ·., '':t\obltE!et?;~i.lg~'':.·;,oi[!'2i!:bfl!'''li' _·::.:::1,,, ';,"•',l.'JI:. ';:.,·.:<.'.'·,):,.'·:·.<':·: .:'-':·:,:r, SD-1 Maintain Natural Drainage Pathways and Hydrologic Features ~s l 0 No j oN/A Discussion/justification if SD-1 not implemented: r I SD-2 Conserve Natural Areas, Soils, and Vegetation \~Yes \ 0 No I D N/A Discussion/justification if SD-2 not implemented: L f\ SD-3 Minimize Impervious Area ~)?es / 0 No I 0 N/A Discussion/justification if SD-3 not implemented: ~ SD-4 Minimize Soil Compaction L'GJ'es I o No joN/A Discussion/justification if SD-4 not implemented: ( SD-5 Impervious Area Dispersion ~n. Yes I o No I 0 N/A Discussion/justification if SD-5 not implemented: l SD-6 Runoff Collection I r:/Yes I o No I 0 N/A Discussion/justification if SD-6 not implemented: t ~A SD-7 Landscaping with Native or Drought Tolerant Species I flj.:Yes I 0 No I 0 N/A Discussion/justification if SD-7 not implemented: l ..... SD-8 Harvesting and Using Precipitation I bYes I o No I 0 N/A Discussion/justification if SD-8 not implemented: I E-36 Page 3 of 3 REV. 02/16 • STORM WATER COMPLIANCE FORM C(?>cfo-07rf TIER-1 CONSTRUCTION SWPPP sw___w_-c)~ E-29 STORM WATER POLLUTION PREVENTION NOTES BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE Erosion Control Sediment Control BMPs Tracking Non-Storm Water Waste Management and Materials 1. ALL NECESSARY EQUIPMENT AND MATERIALS SHALL BE BMPs Control BMPs Management BMPs Pollution Control BMPs AVAILABLE ON SITE TO FACILITATE RAPID INSTALLATION c ...... OF EROSION AND SEDIMENT CONTROL BMPs WHEN RAIN c c: 0 ...... 0 0 :;::::; c c "'t:l :;::::; :;::::; 0'1 0 (IJ "'t:l (IJ "'t:l IS EMINENT. en c 0 0 c c 0'1 E c E c ...... 0 :J :J 0 ·;;: 0 ...... 'C a. 0 0 E (IJ ..... ..... :;::::; ..... ·:; >. (IJ (IJ THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION ::::E -c en Ol ..... ...... ....... c <::::::... Ol ...... (IJ 2. CCIJ ..... c (IJ c en en en §? ·;;: t:r ..... 0 c en ...... Ol a. (IJ ·;;: -Cen c: ..... w -~ c 0 c en Best Management Practice* .:c:! c co 0 CD ·a. ..... (.!) (IJ :;::::; ;::: ...... CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION en3: en ..... ..... OCIJ 0 (IJ ...... (IJ c ...... 0+' ..c: c 1-(IJ 0 c u .... (,) en ~ "'t:l a; en ::::E c CIJC: c :;:c OF THE CITY INSPECTOR AFTER EACH RUN-OFF PRODUCING (BMP) Description ---7 en 0 QJVl ·a (IJ E en Ol CIJo> CD ·a c: Ol c "'t:len c Cl ::::> ~ -+-'(IJ CI)CIJ (IJ (IJ ::; ~(IJ ...... 0 0 3:c '-o -ow "'0>. oen cc COl ~E :JE (IJE :a ..... 0 c: Cl 0 CD V)•-Ol Cl:;::; CIJ'-., (,)CIJ co ~ (IJ ::::E Clo> Cl c E ~0 (IJ E8. c ...__ 3:CIJ oCIJ -+-'(IJ RAINFALL. X (IJ (IJ 0::: c E~ Ncn 0 Cl:z:; ~ .!: ·a. a..e "'COl (IJO'l 0 E ~ +':J ..c =~ :=3: ..... ·-::0 ·;;: Ol (IJ (IJ LL. ~ co 0 c '-o .Y. 5o be ...... "'t:l ..C:c 0 ..... (IJ:J "'t:l ·--c 20 ·-..... 0 (IJ.._ (IJ 0 _ ....... -cO 0 0 ....... _ a. 'C (IJ Q) CIJo c ............ ..c.._ ..co E;~ ...... ·-c ...... o ...... = c =a§ N C c c 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION ~ '-0 0 ...... ..c 0 !:;o 00 COl .Bo c c 0 ..c(IJ c ...... 0 0 a.o c 0 0 0 (IJ 01.-(IJ ..c: ..... 0 ...... ..... Vl£ :s::ct ~(3 ....... (.!) WCI 175 Vi Vl (,) li: (.!) Vl> Vl Vl a.. VlC::: 0..0 a.. ::::EVl ::::E Vl Vl(,) Vl::::E ~::::E U::::E CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY INSPECTOR DUE TO INCOMPLETE GRADING OPERATIONS OR CASQA Designation ---7 ,..... co en -I"') ""'" LO ,..... co 0 "' -I"') ,..... co I "' I"') ""'" LO tO co --tO I I I I I I I I I I I I I I I I I I I I I I I I UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. / Construction Activity (,) (,) (,) (,) w w w w w w w w g: g: Vl Vl Vl Vl ~ ~ ~ ~ ~ ~ ~ w w w w Vl I/Vl Vl Vl Vl Vl Vl Vl z z z z 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE ,;Gr'ading/Soil Disturbance / / AT THE END OF EACH WORKING DAY WHEN THE FIVE (5) .trrenching/Excavation ./ DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ~tockpiling / ~~ ( 40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER Drillinq/Borinq EACH RAINFALL. 1/. Concrete/ Asphalt Sawcutting .-:: v 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM / Concrete Flatwork r ~ Paving AGGREGATE. v Conduit/Pipe Installation " 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER Stucco/Mortar Work I.,... PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST / Waste Disposal / BE INSTALLED AND MAINTAINED. Staging/Lay Down Area Equipment Maintenance and Fueling 7. THE CITY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER Hazardous Substance Use/Storage THIS PLAN DURING OR BEFORE CONSTRUCTION AS NEEDED Dewatering TO ENSURE COMPLIANCE WITH CITY STORM WATER QUALITY Site Access Across Dirt REGULATIONS. other {list): Instructions: 1. Check the box to the left of all applicable construction activity (first column) expected to occur during construction. 2. Located along the top of the BMP Table is a list of BMP's with it's corresfJonding California Stormwater Quality Association (CASQA) designation number. Choose one or more BMPs you intend to use during construction from the list. Check he box where the chosen activity row intersects with the BMP column. 3. Refer to the CASQA construction handbook for information and details of the chosen BMPs and how to apply them to the project. OWNER'S CERTIFICATE: -- I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES {BMPS) DURING CONSTRUCTION PROJECT INFORMATION , ACTIVITIES TO THE MAXIMUM EXTENT PRACTICABLE TO AVOID Site Addres"' g.{Ct ( \ l).g, ( ~ l'f\ ~\-THE MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO AVOID THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED POLLUTANTS; AND {2) ADHERE TO, AND AT ALL TIMES, Assessor's Parcel Numbe;ae:::£:?-~ f~ \ -l)) COMPLY WITH THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP THROUGHOUT THE DURATION OF THE CONSTRUCTION ACTIVITIES Emergency Contact: ;=Ji: ~~K IS COMPLETE AND APPROVED Name: ~ ~'"(' AR B . 24 Hour Phone:f"\,(to-C('l.ob-~34 OWNER(S)/OWNER1S ~T ~ (PRINT) Cur~\~ ~ Construction Threat to Storm Water Quality {Check Box) OWNER(S)/OWNER S AGENT NAME (SIGNATURE) DATE ~EDIUM 0 LOW E-29 Page 1 of 1 I REV 02/16 «~~" ~ CITY OF CARLSBAD PLANNING DIVISION BUILDING PLAN CHECK APPROVAL P-29 DATE: 2-29-16 PROJECT NAME: PROJECTID: Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.eov PLAN CHECK NO: CB 16-0771 SET#: 1 ADDRESS: 2491 Wellspring St APN: 208-192-91-00 [g] This plan check review is complete and has been APPROVED by the Planning Division. By: Chris Sexton A Final Inspection by the Planning Division is required 0 Yes [8] No You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. D This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL has been sent to: carriejones@hotmail.com For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING ENGINEERING FIRE PREVENTION 76()..6()24610 76o.:eo2~2750 76o-602466S ~ Chris Sexton D Chris Glassen D Greg Ryan 76Q-602-4624 760-602-2784 760-602-4663 Chris.Sexton~carl~badca.gov Christopher.Giassen@carlsbadca.gov Gregory.Ryan@carl~badca.gov D Gina Ruiz D VaiRay Marshall D Cindy Wong 760..602-4675 760-602-27 41 760..602-4662 Gina.Ruiz@carlsbadca.gov VaiRay.Marshall@carlsbadca.gov Cynthia.Wong@carlsbadca.gov D Veronica Morones D Linda Ontiveros D Dominic Fieri 760-602-4619 760..602-2773 760-602-4664 Veronica.Morones@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Dominic.Fieri@carlsbadca.gov Remarks: