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HomeMy WebLinkAbout2639 MARQUITA PL; ; CB983213; PermitV L/0/3 B U I L D I N G P E R M I T Permit No: CB98321 3 Project No: A9804195 Development No: 10/09/98 14:58 Paqe 1 of 1 'Job Address: 2639 MARQUITA PL Permit Type: RESIDENTAL ADD/ALT Parcel No: 216-251-12-00 Valuation: 18,424 Suite: Lot#: Occupancy Group: Reference#: Description: 188 SF ADDITION TO MASTER BED/ : BATH Appl/Ownr : HESTON, JIMMY 6803 EL FUERTE ST CARLSBAD CA 92009 *** Fees Required Fees: Adjustments : Total Fees : Fee description Building Permit Plan Check Strong Motion Fee * BUILDING TOTAL *** Enter "Y" for Plumbi r Each Plumbing Fixtur Each Building Sewer Each Install/Repair W Each Vacuum Breaker Enter "Y" for Electric Enter "Y" for Remodel Enter 'Y' for Mechanical Each Exhaust Fan 760 Construction Type: Status : Applied: Apr/Issue: Entered By : 438-3104 VN ISSUED 09/23/98 10/09/98 RMA *** 02 Ext fee Data 192.00 125.00 2.00 319.00 20.00 Y 35 .00 15.00 7.00 7.00 10.00 Y 10.00 Y 15.00 Y 6.50 320-00 r.LEARANCE __ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 \)' ✓-~-s11 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 1. PROJECT INFORMATION b ~i;..31 m~...-7v, Address (include Bldg/Suite #) .Lot-t../3'1 L 'i. los f ..:.. S Legal Description rY) e..(' 4:/::-C:60 Lot No. Assessor's Parcel # 2. CONTACT PERSON (If different~ applicant) 77 ~ 'J.5 u '-L..~ ~.:; "' Name Address Business Name (at this address) #L City State/Zip 3. APPLICANT O Contractor O Agent for Contractor 0 Owner ~ Agent for Owner Name 4. PROPERTY OWNER Name Address 13rr"'t(' .f a..,J,,. 2 C .:J~ Yl:t <--~ V l J... Add ss 6. CONTRACTOR • COMPANY NAME City State/Zip City State/Zip Total # of units ms C-PRMT 125-00 « ?ro..r?I '?/3 5 Telephone # Fax # 6<it-C/tc/6 F Telephone# Telephone# (Sec. 7031.6 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 an applic,nt for a permit subjects the applicant to a c~enaltr of not more than five/hu~dred1dollars ($5001). ::s <.. '<'("' s ~ c 1,03 EJ fv N r r ~ ~ 0-Y <;b,d.. ('"49 "J z..oo Name State License # _,_! -~--'-g-~_,_'is-'--_5'.___ License Class -C&--..... ~-----City State/Zip Telephone# 7,0 "f.!,a>" 3/CJ'-j City Business License # _______ _ G '31? ;-ZE= t Designer Name 7:v • .,,, I-,-s.:r Address City State/Zip Telephone State License # __ /....;.?'"'_:;3_3.:;_C __ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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' 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 _____________________ Policy No._____________ Expiration Date _______ _ es SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) J2!l, CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the W er Compensation Laws of California. WARNING: Failure to se thousand dollars ($100, cov rage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred sation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE __ ---,~IC..e~~;,L-..,..::~LJ,,,&,,~::==,.,..~------------- 7. DATE 2 2 2.. rr I hereby affirm t t I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 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. 0 YES O NO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): ______________________________________________ _ 5. I will provide some of the work, but I have contracted (hired I the following persons to provide the work indicated (include name / address / phone number / type of work):. ________________________________________________________ _ PROPERTY OWNER SIGNATURE _______________________ _ DATE _________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 26633 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ________________________ _ 9. APPLICANT CERTIFICATION 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 Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE ovislons of this Code shall expire by limitation and become null and void if the building or m the date of such permit or if the building or work authorized by such permit is suspended nlf"l'lf-"-'l<~ays (Section 106.4.4 Uniform Building Code). DATE 7 . YELLOW: Applicant PINK: Finance JJL/l City of Carlsbad Inspection Request For: 7 /28/99 Permit# CB983213 Title: 188 SF ADDITION TO MASTER BED/ Description: BATH Type:RAD Sub Type: Job Address: Suite: Location: 2639 MARQUITA PL Lot APPLICANT HESTON, JIMMY Owner: THOMPSON REVOCABLE TRUST 11-05-9 Remarks: CHECK TEMPERING(SIDE GATE OPEN) Total Time: CD Description Act Comments 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Inspection History Date Description Act lnsp Comments Inspector Assignment: DH --- Phone: 7606327467 Inspector: lJ/~ Requested By: CANDICE Entered By: CHRISTINE 7/9/99 19 Final Structural co DH NOONE HOME 6/1/99 89 Final Combo co DH WINDOW ABOVE TUB NEEDS TO BE TEMPERED 12/17/98 17 Interior Lath/Drywall AP DH 12/17/98 18 Exterior Lath/Drywall AP DH 12/14/98 16 Insulation AP DH 12/10/98 14 Frame/Steel/Bolting/Welding AP DH 12/8/98 84 Rough Combo co DH WATER TEST/ BLOCKING 12/4/98 84 Rough Combo co DH LISTON CARD 11/19/98 15 Roof/Reroof AP DH SHEATHING 10/30/98 11 Fig/Foundation/Piers AP DH 10/29/98 11 Ftg/Foundation/Piers co DH ADD STEEL 10/28/98 21 Underground/Under Floor AP DH --------------------· EsGil Corporation 1n Partnwliip Witli (jov,mm,nt for 'Buifaing Safety DATE: 10/6/98 JURISDICTION: Carlsbad PLAN CHECK NO.: 98-3213 PROJECT ADDRESS: 2639 Marquita Pl. PROJECT NAME: Fox Room/Bath Addition SET:I 9--,APPUfANT ~: □ PLAN REVIEWER □ FILE D The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. [;8J The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified in Remarks below are resolved and checked by building department staff. D The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. 0 The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. D The applicant's copy of the check list has been sent to: [;8J Esgil Corporation staff did not advise the applicant that the plan check has been completed. D Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone#: Date contacted: (by: ) Fax#: Mail Telephone Fax In Person C8J REMARKS: Please make the notes as circled in red on sheets A 1, A2 and A3 of the Owner Set I to the City Set I. Please have the applicant provide the roof covering manufacturer and ICBO approval listing number as circled on sheet A2 By: Mike Puckett Esgil Corporation 0 GA O MB O EJ O PC Enclosures: 9/28/98 tmsmtl.dot 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (619) 560-1468 ♦ Fax (619) 560-1576 .• Carlsbad 98-3213 10/6/98 PLAN REVIEW CORRECTION LIST SINGLE FAMILY DWELLINGS AND DUPLEXES PLAN CHECK NO.: 98-3213 PROJECT ADDRESS: 2639 Marquita Pl. FLOOR AREA: 188sf Add REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 9/23/98 DATE INITIAL PLAN REVIEW COMPLETED: 10/6/98 FOREWORD {PLEASE READ): JURISDICTION: Carlsbad STORIES: 1 HEIGHT: DATE PLANS RECEIVED BY ESGIL CORPORATION: 9/28/98 PLAN REVIEWER: Mike Puckett This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled. This plan review is based on regulations enforced by the Building Department. You may have other corrections based on laws and ordinance by the Planning Department, Engineering Department, Fire Department or other departments. Clearance from those departments may be required prior to the issuance of a building permit. Present California law mandates that residential construction comply with Title 24 and the following model codes: 1994 UBC (effective 12/28/95), 1994 UPC (effective 12/28/95), 1994 UMC (effective 2/23/96) and 1993 NEC (effective 12/28/95). The above regulations apply to residential construction, regardless of the code editions adopted by ordinance. The following items listed need clarification, modification or change. All items must be satisfied before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3, 1994 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law. To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e .. plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. LIST NO. 1, GENERAL SINGLE FAMILY DWELLINGS AND DUPLEXES WITHOUT SUPPLEMENTS (1994 UBC) r3forw.dot Carlsbad 98-3213 10/6/98 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 98-3213 PREPARED BY: Mike Puckett DATE: 10/6/98 BUILDING ADDRESS: 2639 Marquita Pl. BUILDING OCCUPANCY: R3 TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA VALUATION VALUE (ft. 2) MULTIPLIER ($) Room/Bath Addition 188sf 98.00 18,424.00 Air ConditioninQ Fire Sprinklers TOTAL VALUE 18,424.00 0 1994 UBC Building Permit Fee t8:] Bldg. Permit Fee by ordinance: $ 192.33 0 1994 UBC Plan Check Fee t8:] Plan Check Fee by ordinance: $ 125.01 Type of Review: 0 Complete Review O Structural Only O Hourly 0 Repetitive Fee Applicable O Other: Esgil Plan Review Fee: $ 100.01 Comments: Sheet 1 of 1 macvalue.doc 5196 City of Carlsbad ■ 3 ,;. 11,14411,1· i•JA•fil ;; ,,14,1 I BUILDING PLANCHECK CHECKLIST DATE: /0-(-98 ' PLANCHECK NO.: CB9@3ol/3 BUILDING ADDRESS: c'.2'239 M~vA:e. Pio ,g PROJECT DESCRIPTION: 8EB, ~ \, I ) \b:::c:o,... ASSESSOR'S PARCEL NUMBER: c£../[p -6'-5:1 -1 :;2, ENGINEERING DEPARTMENT APPROVAL EST. VALUE: DENIAL 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. Cl Right-of-Way permit is required prior to construction of the following improvements: Please see the attached report of deficiencies marked with □. 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. By: Date: By: ________ Date: By: ________ Date: FOR OFFICIAL USE ONLY ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT: [! Dedication Application □ Dedication Checklist □ Improvement Application □ Improvement Checklist !] Future Improvement Agreement □ Grading Permit Application □ Grading Submittal Checklist □ Right-of-Way Permit Application [! Right-of-Way Permit Submittal Checklist and Information Sheet D Sewer Fee Information Sheet Date: /!J-;--:9B ENGINEERING DEPT. CONTACT PERSON Name: JOANNE JUCHNIEWICZ City of Carlsbad Address: 2075 Las Palmas Dr., Carlsbad, CA 92009 Phone: (619) 438-1161, ext. 4510 CFD INFORMATION Parcel Map No: Lots: Recordation: Carlsbad Tract: A-4 H,woR0"2'G'?S'll'a~fllalt'll,<ers•l!!lf'.FomQlarlsbad, CA 92009-,576 • (760) 438-1161 • FAX (760) 4@.12':§0P'69 D D D D D D D BUILDING PLANCHECK CHECKLIST SITE PLAN 1. Provide a fully dimensioned site plan drawn to scale. Show: A. North Arrow D. Property Lines B. Existing & Proposed Structures E. Easements Le.+ I( 3'/ U..Co?i~~,,.,.__.,i.6'6 ~ ,,Clf I 71$-osl) 1§ i ;iiJ er Bo/-01/ C. Existing Street Improvements F. Right-of-Way Width & Adjacent Streets G. Driveway widths 2. Show on site plan: A. Drainage Patterns 1. Building pad surface drainage must maintain a minimum slope of one percent towards an adjoining street or an approved drainage course. 2. ADD THE FOLLOWING NOTE: "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building." B. Existing & Proposed Slopes and Topography 3. Include on title sheet: A. Site address B. Assessor's Parcel Number C. Legal Description For commercial/industrial buildings and tenant improvement projects, include: total building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc.) previously approved. EXISTING PERMIT NUMBER DESCRIPTION DISCRETIONARY APPROVAL COMPLIANCE 4a. Project does not comply with the following Engineering Conditions of approval for Project No. ________________________ _ 4b. All conditions are in compliance. Date: __________ _ H·\WORDIDOCSICHKLST\BuildIr,g P~check Cklst BP0001 Form JJ.doc 2 Rev. 12.l2tl/96 0 0 0 0 0 BUILDING PLANCHECK CHECKLIST DEDICATION REQUIREMENTS 5. Dedication for all street Rights-of-Way adjacent to the building site and any storm drain or utility easements on the building site is required for all new buildings and for remodels with a value at or exceeding $ ______ ,, pursuant to Carlsbad Municipal Code Section 18.40.030. Dedication required as follows: _________________ _ Dedication required. Please have a registered Civil Engineer or Land Surveyor prepare the appropriate legal description together with an 8 ½" x 11" plat map and submit with a title report. All easement documents must be approved and signed by owner(s) prior to issuance of Building Permit. Attached please find an application form and submittal checklist for the dedication process. Submit the completed application form with the required checklist items and fees to the Engineering Department in person. Applications will not be accept by mail or fax. Dedication completed by: ___________ _ Date: ____ _ IMPROVEMENT REQUIREMENTS 6a. All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $ _______ , pursuant to Carlsbad Municipal Code Section 18.40.040. Public improvements required as follows: _____________ _ Attached please find an application form and submittal checklist for the public improvement requirements. A registered Civil Engineer must prepare the appropriate improvement plans and submit them together with the requirements on the attached checklist to the Engineering Department through a separate plan check process. The completed application form and the requirements on the checklist must be submitted in person. Applications by mail or fax are not accepted. Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of building permit. Improvement Plans signed by: __________ _ Date: ____ _ 6b. Construction of the public improvements may be deferred pursuant to Carlsbad Municipal Code Section 18.40. Please submit a recent property title report or current grant deed on the property and processing fee of$ _______ so we may prepare the necessary Future Improvement Agreement. This agreement must be signed, notarized and approved by the City prior to issuance of a Building permit. Future public improvements required as follows: H:IWORD\OOCSICHKLST\Buik:ling Plancheek Cklst BP0001 Form JJ.doc 3 Rev. 12126196 1st✓ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ BUILDING PLANCHECK CHECKLIST 6c. Enclosed please find your Future Improvement Agreement. Please return agreement signed and notarized to the Engineering Department. Future Improvement Agreement completed by: Date: 6d. No Public Improvements required. SPECIAL NOTE: Damaged or defective improvements found adjacent to building site must be repaired to the satisfaction of the City Inspector prior to occupancy. GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 11.06.030 of the Municipal Code. 7a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill import, export). 7b. 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. Grading Inspector sign off by: Date: ----------- 7c. Graded Pad Certification required. (Note: Pad certification may be required even if a grading permit is not required.) 7d.No Grading Permit required. 7e.lf grading is not required, write "No Grading" on plot plan. MISCELLANEOUS PERMITS 8. 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. Types of work include, but are not limited to: street improvements, tree trimming, driveway construction, tieing into public storm drain, sewer and water utilities. Right-of-Way permit required for: H:IWORD\OOCS\CHKLSTl8uildi~ Plancheck Ckl5t BP0001 Form JJ.doc BUILDING PLANCHECK CHECKLIST 4 Rev. 12126196 0 0 0 0 0 0 9. A SEWER PERMIT is required concurrent with the building permit issuance. The fee is noted in the fees section on the following page. 10. INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad sewer service area, you need to contact the Carlsbad Municipal Water District, located at 5950 El Camino Real, Carlsbad, CA 92008. District personnel can provide forms and assistance, and will check to see if your business enterprise is on the EWA Exempt List. You may telephone (760) 438-2722, extension 153, for assistance. Industrial Waste permit accepted by: Date: 11. NPDES PERMIT Complies with the City's requirements of the National Pollutant Discharge Elimination System (NPDES) permit. The applicant shall provide best management practices to reduce surface pollutants to an acceptable level prior to discharge to sensitive areas. Plans for such improvements shall be approved by the City Engineer prior to issuance of grading or building permit, whichever occurs first. 12. O Required fees are attached O No fees required 13. Additional Comments: f-l"IWOROIOOCS\CHKLST\Bu\lding Plancheck Cid$! SP0001 Form JJ.doc 5 Rev. 12126196 ~ ~ ~ ~ ~ M " ~ ~ u u • • ~ ~ u u C C C le. • • a: a: PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No. CB 9'6' 3?.I > Address '.20:S'! ,/41a...-l v;+.. fl Phone (619) 438-1161, extension _,_'(? ... 4.,.E,: __ Type of Project & Use: Rdo-c.,M;t; • ., Net Project Density: _____ .,,D<->U,,.,/c.;:A,,C"-- Zoning: R~I General Plan: ltL.M Facilities Management Zone: _ _,0'---- CFD /in/n11tl # ___ Date of participation: ~ Circle Ohe Remaining net dev acres: __ _ (For non-residential development: Type of land used created by this permit: _____________________ ) Legend: ~ Item Complete (Qi Item Incomplete -Needs your action ~ D D Environmental Review Required: YES NO TYPE ----- DATE OF COMPLETION: ______ _ Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: ~ D D Discretionary Action Required: YES NO TYPE ----- APPROVAL/RESO. NO. _____ DATE ___ _ PROJECT NO. _______ _ OTHER RELATED CASES: __________________ _ Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: ________________________ _ og D D Coastal Zone Assessment/Compliance · Project site located in Coastal Zone? YES CA Coastal Commission Authority? YES NO/ NO If California Coastal Commission Authority: Contact them at -3111 Camino Del Rio North, Suite 200, San Diego CA 92108-1725; (619) 521-8036 Determine status (Coastal Permit Required or Exempt): Coastal Permit Determination Form already completed? YES NO If NO, complete Coastal Permit Determination Form now. Coastal Permit Determination Log #: Follow-Up Actions: 1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum Floor Plans). 2) Complete Coastal Permit Determination Log as needed. jl] □ □ lnclusionary Housing Fee required: YES NO / (Effective date of lnclusionary Housing Ordinance -May 21, 1993.) Data Entry Completed? YES __ NO __ (Enter CB#; UACT; NEXT12; Construct housing Y/N; Enter Fee Amount {See fee schedule for amount); Return) Site Plan: [i] D D 1. Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of-way width, dimensional setbacks and existing topographical lines. [l] D D 2. Provide legal description of property and assessor's parcel number. Zoning: ~ □ □ 1 . Setbacks: Front: Required z.o' Shown z),·. 1 · Interior Side: Required s..~-, Shown ~.j-, Street Side: Required Shown Rear: Required H I Shown /g' ~ □ □ 2. Accessory structure setbacks: Front: Requiree~d =======--===---:~:~=--=-=-=-=----Requir0 Shown ______ _ equired _______ Shown ______ _ Required _______ Shown ______ _ Structure separation: Required _______ Shown ______ _ [l] D D 3. Lot Coverage: Required __ l_,_(_0 _i __ _ Shown .:'.. 4 ~ /• li:I O O 4. Height: 7 o' Required ___ ':> ___ _ Shown 3 1 --'=------ D D 5. Parking: Spaces Required---''-"-----Shown -=------ Guest Spaces Required ______ _ Shown ------- D D D Additional Comments _________________________ _