Loading...
HomeMy WebLinkAbout2570 DISCOVERY RD; ; CB062445; Permit09-11-2006, City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No CB062445 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2570 DISCOVERY RD CBAD POOL 2131301400 Lot* 0 $3,790 00 Construction Type NEW HETTICH RESIDENCE 44 SF SPA WITH 7 FT FIREPLACE Status ISSUED Applied 08/25/2006 MDP 09/11/2006 09/11/2006 Entered By Plan Approved Issued Inspect Area Applicant TERRA FIRMA LANDSCAPE 9550 WAPLES SAN DIEGO CA 92121 RMA Owner HETTICH JOACHIM F X 2570 DISCOVERY RD CARLSBAD CA 92009 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees $5349 $000 $3477 $000 $2000 $2700 $1 00 $000 $000 $000 $000 TOTAL PERMIT FEES $13626 Total Fees $136 26 Total Payments To Date $13626 Balance Due $000 BUJLDING PLA IN STORAGE ATTACHED Inspector FINA 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 muM 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 limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 nPWWECT INFORMATIC\-7 -•* v PLAN CHECK EST VAL /2°°6 Plan Ck Deposit Validated By Date Address (mcTude Bldg/Suite #) X Business Name (at this address) Legal Description V Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel # /_ELAO- Existing Use Proposed Use Descriptor! If Work 2 CONTACT £ERSON (if different from applicant) SQ FT #of Stories # of Bedrooms ddress City it for Contractor::: Q Owner Q] Agent for OwnerAgent f_B Name Address 5 CONTRACTOR - COMPANY NAME (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 has s for the alleged exemrJtlsn Any violation of Section 7031 5 by any applicant for a permit subjects.the applicant to a civil penalty of not more than fivejiundred dollars [$500])F"iV/vNg> nn\Q/W\4 AName State ddress License # _H3S_!Z£) .License Class C<>3/& . I ^ 2.1 City Statefeip City Business License # Telephone it ^W Designer Narrle Address * ^ *-"JN* ^«€tty State/Zip Telephone State License # HB-W WORKERS'LCOMPENSAflON m,oUV "" '" ..:.- .*f .. •••:*«;:. '" . • ,.,«Jjjp ' Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations f~l 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 JBv 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 worker s compensation insurance carrier and policy number are Insurance Company *?*_ LJL/\^_fr^J Policy No LMCi^-ioG^jQ^iQ^ Expiration Date |vl/ 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 ciny 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 OQgJ—m addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE . "^V V. ** 'i --. *4C \ -^-g"! /V"" DATE 7 if OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s License tawlfor the following reason l~l I, as owner of the property or my employees with wages aytheir sole compensation will do the work and the structure is not intended or offered for sale ~f5ee-»0!044, 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 worR~hhfns£lf 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 ySa7t>f~c.g.mpletion, the owner-builder will have the burden of proving that he did not build or improve for the pjjrpoSe of sale) n I, as owner of the propertyTaTn-ej^clusively contracting with licensed contractors to construct the project (Sec-'7044, Business and Profes .ions Code The Contractor's License Law does not apply t3"~an-oyvner of property who builds or improves thereon, arid^corftracts for such projects with contiactor(s) licensed pursuant to the Contractor's License Law) I am exempt under Section Business and ProfeSSKiiisCode for this .reas'dn I personally plan to provide the major labor and materials for constructipn of tfie-ptgppsed property improvement l~| YES r~lNO I (have / have not) signed an application for a building permit-fbr"the proposed work I have contracted with the following person tf.irm)"to" provide the proposed construction (included ^/address / phone number / contractois license number) 4 I plan to provide portjjjns-oTtne work, but I have hired the following person to coordinate, supervise and provide number / contractcrsJtcBfise number) 5 I will of woj letfTBvmajor vwork (include name / address / phone Tide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name i |ress / phone number / type PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION fOfl NON-RESIDENTIAL BUILDING PERMITSi ONLY . ;i i "Spr .„":. te-the-apphcant^or future building occupant required to submit a business plan acutely hazardous materials registration form or risk management and prevention program under SectiortS-25505,_25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES FJ NO —--"""" Is the applicant or future building occupant requffe'd to obtairj,.a_permit from the air pollution control district or air quality-management district' l~l YES l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a~sc"hDol siteT^Q—YES \\ NO IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCYHMAYNOT BE ISSUED~DNtESS-IHE_APPUCANT HAS MET OR IS MI.ETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND -THE MR POLLUTION CONTROL DISTRICT 8. CONSTRUCTION LENDING AGENCY,. ~~ I hereby affirm that therejs^a-eortsTruction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S ADDRESS APPLICANT CERTIFICATION!!!-: •.,:•::•::••:- ../•*%* 'it, I* „ I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate I agree to comply with all City ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the dbove mentioned property for inspection purposes I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if thp building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comrrieflceeHer-^jperiod of 180 llays (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATU DATE ELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/01/2007 Permit* CB062445 Title HETTICH RESIDENCE Description 44 SF SPA WITH 7 FT FIREPLACE Inspector Assignment PC 2570 DISCOVERY RD Lot 0 Type POOL Sub Type Job Address Suite Location APPLICANT TERRA FIRMA LANDSCAPE Owner HETTICH JOACHIM F X Remarks . Phone 7609210026 Inspector Total Time CD Description 59 Final Pool Requested By JESUS Entered By CHRISTINE Act Comment Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp 01/22/2007 55 Fence/Pre-Plaster AP JM 11/14/2006 51 Excav/Steel/Bondmg/Fence AP PC 11/13/2006 51 Excav/Steel/Bonding/Fence CO PC 11/13/2006 52 Underground Plumbing AP PC 11/13/2006 53 Electric/Conduit/Wiring AP PC 10/24/2006 68 Fireplace/Tie Straps AP PC 10/16/2006 61 Footing AP PC 10/11/2006 23 Gas/Test/Repairs AP PC 10/11/2006 53 Electric/Conduit/Wiring PA PC Comments OK TO PLASTER - ALARMS OK TEMP FENCE IN FENCE ON LEFT SIDE NOT IN POOL BONDING OK FIREPLACE City of Carlsbad Public Works — Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER CB BUILDING ADDRESS PROJECT DESCRIPTION Pool ASSESSOR'S PARCEL NUMBER c2i3 ' ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved The approval is based on plans, information and/or specifications provided in your submittal, therefore, any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build Date DENIAL Please seeVie.affached report of deficiencies marked with J53 Make necessary corrections to plans or /specifications for compliance with applicable codes\and standards Submit corrected plans and/or specifications to this office for review ATTACHMENTS Grading Permit Application Grading Permit Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME JOANNE JUCHNIEWICZ City of Carlsbad ADDRESS 1635 Faraday Avenue Carlsbad, CA 92008 PHONE (760) 602-2775 H \WORD\DOCSCHKlS-nPool Building Plancheck CKIist CHK24 Form BE.dor 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (76O) 6O2-272O « FAX (76O) 602-8562 a BUILDING PLANCHECK CHECKLIST - POOLS SITE PLAN 1 Provide a fully dimensioned site plan drawn to scale Show A North Arrow B Existing & Showo Structures )ramage Patterns Existing & Proposed Slopes C Existing Topography C Property Lines D Easements 0,/fndicate what will happen with soil excavated from pool area E- Retaining Walls (location and height) Note- If excavated soil is not to be removed from property but regraded on site, show proposed elevations and slopes. If any portion of retaining walls are over 4' in height, a separate permit is required Retaining Wall Permit CB Applied for Approved 3 Include on title sheet A Site Address Assessor's Parcel Number Legal Description D Grading Quantities Cut Fill Import/Export a) If grading is not required, write "No Grading" on plot plan Project does not comply with the following Engineering Conditions of approval for Project No Conditions were complied with by GRADING PERMIT REQUIREMENTS Date The conditions that invoke the need for grading permit are found in Section 11 06 030 of the Municipal code 5a Inadequate information available on Site Plan to make a determination on grading requirements Include accurate grading quantities (cut, fill, import, export) 5b Grading Permit required A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached Note- The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Page 2 of 2 H \WORD\DOCS\CHKUSTVPool Building Plancheck Ckhst CHK24 Form BE doc 4 ST/ 2N£V 3RDv' Q Q Q 5c A Grading Permit has been applied for PE2 DWG Grading Inspector sign off by Date Q 5d No Grading Permit required MISCELLANEOUS PERMITS Q 6 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 Department 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 Building Permit will be issued simultaneously Q Q 7 Remarks H \WORD\DOCS\CHKlST\Poo! Building Ptancheck Cklist CHK24 Form BE doc PLANNING/ENGINEERING APPROVALS PERMIT NUMBER £B. ADDRESS S C9 DATE j D(Q 77 RESIDENTIAL RESIDENTIAL ADDITION MINOR « $1O,OOO.OO) TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE J PVC FL 355.9 7W 357.0 3" PVC FL 351.9 3" PVC IbKKAMK ACORD™ CERTIFICATE OF LIABI PRODUCER John Burnham SO 1612 750 B Street, Suite 2400 ~™ Diego, CA 92101-2476 0421-6744 INSURED Terra Firma Landscape Company (L A. Swikard, Inc dba ) 7710 KenamarCt San Diego, CA 92121 LITY INSURANCE DATE (MM/DD/YYYY) 09/26/05 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 Zuncn^Amencan Ins Co (Captive) INSURER B INSURER C INSURER D INSURER E NAIC# 16535 COVERAGES 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 1NSR LTR A ADD'LINSRC TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | | OCCUR GEN L AGGREGATE LIMIT APPLIES PER~i POUCY rijpER& r~Koc AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY __J ANY AUTO EXCESS/UMBRELLA LIABILITY ] OCCUR II CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER POUCY NUMBER WC21 8680306 POLICY EFFECTIVEDATE (MMFDDWn 10/01/05 POLICY EXPIRATIONDATE IMM/DD/YY) 10/01/06 LIMITS EACH OCCURRENCE DAMAGE TO RENTEDPREMISES (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) I $ $ S S S $ $ J S AUTO ONLY - EA ACCIDENT i S OTHER THAN . %£ ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE X I WCSTATU- 1 1 TORY LIMITS 1 E L EACH ACCIDENT OTH- ER E L DISEASE - EA EMPLOYEE EL DISEASE POLICY LIMIT S S $ $ $ $ $ 11,000,000 $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT ) SPECIAL PROVISIONS Certificate is subject to all policy-limits, conditions, and exclusions. RE ALL OPERATIONS PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. CERTIFICATE HOLDER CANCELLATION TerLDav Notice for Non-Pavment of Premium CITY OF SAN DIEGO BUILDING INSPECTION DEPARTMENT 1222 FIRST AVE.MS201 S AN DIEGO, C A 92101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3tt_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE J^ <?...J%# ACORD 25 (2001/08) 1 of 2 #M288954 DSWAL © ACORD CORPORATION 1988 THIS DOCUMENT HAS A TRUE DEFENSA™ WATERMARK AND VISIBLE FIBERS DISCERNIBLE FROM BOTH SIDES BUS NUMBER 1207321 DATE ISSUED 8/10/2006 SIC CODE 17 OWNER FIRM OR CORPORATION NAME BUSINESS NAME MAILING ADDRESS CITY AND STATE CITY OF CARLSBAD BUSINESS REGISTRATION CERTIFICATE POST IN CONSPICUOUS PLACE 7h«c«raon ftm or corporation named below » granted Inn buanou oartilicale pursuant to !bo provision* ot the City Qunnett Ljcente Ordnances to engage mcarry on or conduct In* business trade caltng. profMwon ohibiliort or occupatkxi dovcnbod bdow ls«uanc« ol lh« cwtificat* a not an cncfarMmflnl. nor certification of complianc« vrtlh olhar ordmancM or law* Thw hc«n»e is ntsuad Mlnoul vonficalion that th* llconWM it 5Ub)«cl to or mampt from boansng by th« Slate 04 Calitomia BUSINESS LOCATION 7710KENAMARCT SIC DESCRIPTION Construction-Special Trade Contractors TERRA FIRMA LANDSCAPE CO TERRA FIRMA LANDSCAPE CO 7710KENAMARCT SAN DIEGO, CA 92121-2425 EXPIRATION DATE 8/31/2007 KEEP FOR YOUR RECORDS BUSINESS TAX RECEIPT BUS, NO 1207321 DATE ISSUED 8/10/2006 08 070SUB $6000 BALANCE $000 TAXES PAID IN ACCORDANCE WITH CITY BUSINESS TAX ORDINANCE CITY OF CARLSBAD THIS DOCUMENT IS ALTERATION PROTECTED AND REFLECTS FLUORESCENT FIBERS UNDER UV LIGHT Client* 4873 TERRAFIR A-tRD^ CERTIFICATE OF LIAB8^-^^a Jonn Burrtham Insurance Svcs CA Lie 0099753 / 750 B St , #2400 Diego, CA 92101 , 231-1010 INSURED Terra Firma Landscape Company (LA Swikard, Inc dba ) 7710 Kenamar Ct San Diego, CA 92121 LITY INSURANCE DATE«M™YYY, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIF ICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIEES BELOW INSURERS AFFORDING COVERAGE INSURER A Zurich-American Ins Co INSURERS INSURER C INSURER D INSURER E NAIC# 16535 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR A ADD'L 'NSRO TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I CLAIMS MADE I | OCCUR GEN L AGGREGATE LIMIT APPLIES PER ~H POLICY PI JPEC°T HLOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY | OCCUR I | CLAIMS MADE WORKERS EMPLOYE ANY PROF OFFICER/f Ifves desc SPECIAL F DEDUCTIBLE RETENTION S COMPENSATION AND RS' LIABILITY RIETOR/PARTNER/EXECUTIVE •1EMBER EXCLUDED7 ROVI3IONS Delow OTHER POLICY NUMBER > t WC21 8680305 POLICY EFFECTIVEDATE (MM/DDftT) 10/01/04 POLICY EXPIRATIONDATE (MM/DD/YY) 10/01/05 LIMITS EACH OCCURRENCE DAMAGE TO RENTEDPREMISES (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. <~>THFP THAN ^A AC<' AUTO ONLY AGG EACH OCCURRENCE AGGREGATE V WC STATU- OTH* TORY I IMITS ER EL EACH ACCIDENT EL DISEASE EA EMPLOYEE EL DISEASE POLICV LIMIT S S S $ S S $ $ $ S S $ S S $ S S $ $1,000,000 s1, 000, 000 $1,000,000 DESCRIPTION Or OPERATIONS ' LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT .'SPECIAL PROVISIONS RE LICENSE #495376 CERTIFICATE HOLDER CANCELLATION Ten Dav Notice for Non-Pavment of Premium CONTRACTORS STATE LICENSE BRD ATTN WORKERS COMP UNIT P 0 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 __3£L. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ff jp x» j?3*f—a^A*-ft-v c.-^4^r ACORD 25 (2001/08) -| of 2 #M20122 JRW ® ACORD CORPORATION 1988 LU 0 OK < £ E 2570 DISCOVEIRESIDENCEA WITH 7 FT FIRELJJ Q.< Q 3 TERRA FIRMA