HomeMy WebLinkAbout2735 PALOMAR AIRPORT RD; ; CB142985; Permit01-16-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Pool Permit Permit No: CB142985
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC #:
Project Title:
2735 PALOMAR AIRPORT RD CBAD
POOL
2132621100 Lot#: 0
$144,892.00 Construction Type: 5B
STAYBRIDGE HOTEL:
1675 SF POOL/SPA
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
10/31/2014
JMA
11/14/2014
11/14/2014
PD
Applicant:
LISA ZOSCAK
STE A
32232 PASEO ADELANTO
SAN JUAN CAPISTRANO CA 92675-3600
949-493-9548
Owner:
ALPS INNOVATION LLC
621 S HIGHWAY 101
SOLANA BEACH CA 92075
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Electrical Fee
Plumbing Fee
Strong Motion Fee
Green Bldg Standards (SBl473) Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Additional Fees
$784.91
$0.00
$549.44
$0.00
$33.00
$33.00
$18.84
$4.00
$0.00
$0.00
$0.00
$0.00
TOTAL PERMIT FEES $1,423.19
Total Fees: $1,423.19 Total Payments To Date: $1,423.19 Balance Due: $0.00
Inspector:
FINAL APPROVAL
Date: f ^ ' Clearance:
NOTICE: Please take NOTICE thai 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 v^as 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv otherwise expired
11-14-2014
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Storm Water Pollution Prevention Plan (SWPPP) Permit
Permit No:SW140386
Job Address:
Permit Type:
Parcel No:
Reference #:
CB#:
Project Title:
2735 PALOMAR AIRPORT RD CBAD
SWPPP
2132621100 Lot#:
CB142985
STAYBRIDGE HOTEL:
1675 SF POOL/SPA
Applicant:
LISA ZOSCAK
STE A
32232 PASEO ADELANTO
SAN JUAN CAPISTRANO CA 92675-3600
949-493-9548
Emergency Contact:
DANNY HART
Status
Applied
Entered By
Issued
Inspect Area
Tier:
Owner:
ALPS INNOVATION LLC
621 S HIGHWAY 101
SOLANA BEACH CA 92075
ISSUED
10/31/2014
JMA
11/14/2014
1
Priority:
M
949-351-2373
SWPPP Plan Check
SWPPP Inspections
Additional Fees
$53.00
$224.00
$0.00
TOTAL PERMIT FEES $277.00
Total Fees: $277.00 Total Payments To Date: $277.00 Balance Due: $0.00
FINAL APPROVAL
SIGNATURE
rHE FOLLOUViNG APPROVALS REQUIRED PRiOR TO PERMIT ISSUANCE. BUILOiNi FIRE HEALTH HAZMAT/APCD
^ City of
Ccirlsbo-d
Building Permit Application
1635 Faraday Ave,, Carlsbad, CA 92008
Pti: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
Plan Check No. (2B(^- "^QSS
Est. Value (^^^^9^Z.
Plan Ck. Deposit
Date /Q/3tl(S^ ISWPPP \^''3>8^
JOB ADDRESS 2735 Palomar Airport Road SUITE#/SPACE#/UNIT#
# BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC-GROUP
DESCRIPTION OF WORK; /nc/ude Square Feet of Affected Area(s)
New swimming pool and spa
I
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YES I |# N0| I
AIR CONDITIONING
YES I I NO I I
FIRE SPRINKLERS
YES I |NO| I
APPLICANT NAME
Primary Contact Lisa Zoscak PROPERTY OWNER NAME
32232 Paseo Adelanto, Suite A
ADDRESS
Alps Innovation, LLC
621 South Highway 101
CITY
San Juan Capistrano
STATE
PHONE
949 493-9548
CA 92675
949 493-8495
lisa@aquatictechnologies.com
CITY
PHONE
EMAlir"
Solana Beach
STATE
CA 92075
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME
ADDRESS
CiTY
PHONE
EMAIL
1201 N. Tustin Ave.
ADDRESS
Aquatic Technologies
32232 Paseo Adelanto, Ste A
Anaheim
714 630-6100
STATE
FAX
CA 92807
CITY STATE
San Juan Capistrano CA 92675
714 630-6114
PHONE
949 493-9548 949 493-8495
744177 C53
CITY BUS. LIC.#
1211868
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permitto 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}).
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
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.
^ I have and will maintain workers' compensation, as required bv Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My workers' compensation insurance carrier and policy
number are: Insurance Co _Zurich American _ _ PolicyNo WC4503556-02 Expiration Date
This section need not be completed if the permit is for one hundred dollars (SI 00) or less.
I I Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensatloi! danages as provided for In Section 3T06 of the Labor code, Interest and attorney's fees.
CONTRACTOR SIGNATURE ^/^Y?fA/{ f) A Dl X. [7] AGENT DATE [/O^^^
/ hereby affirm that I am exempt Irom Contractor's License Law for the foUowing reason:
I I 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).
I I 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),
I I I am exempt under Section Business and Professions Code for this reason:
1,1 personally plan to provide the major labor and matenals for construction of the proposed property Improvement, |^Yes | |NO
2.1 (have / have not) signed an application for a building permit for the proposed work,
3,1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
4 I plan to provide portions of the work, bul I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number):
5,1 will provide some ofthe work, but I have contracted (hired) the following persons to provide the work Indicated (include name / address / phone / type of work):
PROPERTY OWNER SIGNATURE QAGENT DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? Yes No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district Yes No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No
;F 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.
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code),
Lender's Name Lender's Address
I certify that I have read the application and state that the above information is consct and that the information on the plans Is accurate. I agree to comply with all Cltyordinancesand State lavws relating to building construction.
I tiereby authorize representative of the City 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,
OSHA: An OSHA pemiit is required for excavations over 5'0' deep and demolition or constnjction of stnictures over 3 stoties in height.
EXPIRATION: Every pemiit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or wot1( authorized by such permit is not commenced within
) days from the date of such pemiit or if jflje building or vwrk authorized by such pemiit is suspended or abandoned at any lime after the wort< is commenced for a period of 180 days (Section 106.4,4 Uniform Building Code),
^APPLICANT'S SIGNATURE
or if lie building or vwrk authorized by such pemiit is su;
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.
Fax (760) 602-8560, Email building(a)carlsbadca.QOV or Mail the completed form to City of Carlsbad, Buildina Division 1635 Faraday Avenue. Carlsbad. Califomia 92008.
C0#: (Office Use Only)
CONTACT NAIVIE : OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
PHONE FAX
ElVIAIL : OCCUPANT'S BUS. LIC, No.
DELIVERY OPTIONS
PICK UP: CONTACT (Usted above)
CONTRACTOR (On Pg. 1)
OCCUPANT (Listed above)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
OCCUPANT (Listed above)
ASSOCIATED CB#
NO CHANGE IN USE / NO CONSTRUCTION
MAIL / FAX TO OTHER:
CHANGE OF USE / NO CONSTRUCTION
^APPLICANT'S SIGNATURE ^ DATE
Inspection List
Permit#: CB142985 Type: POOL
Date Inspection Item Inspector Act
05/12/2015 59 Final Pool PD AP
05/11/2015 59 Final Pool - Rl
05/11/2015 59 Final Pool PD CO
05/08/2015 59 Final Pool - Rl
05/08/2015 59 Final Pool PD CO
04/28/2015 59 Final Pool PD CA
04/20/2015 55 Fence/Pre-Plaster PD AP
03/27/2015 51 Excav/Steel/Bonding/Fence PD AP
12/10/2014 51 Excav/Steel/Bondlng/Fence PD AP
12/09/2014 51 Excav/Steel/Bonding/Fence PD CO
12/04/2014 51 Excav/Steel/Bonding/Fence PD CO
STAYBRIDGE HOTEL:
1675 SF POOL/SPA
Comments
AM PLEASE/ STAYBRIDGE
EMAILING CARD/ STAYBRIDGE
Thursday, May 14, 2015 Page 1 of 1
EsGil Corporation
In (Partnersfiip witti government for (BuiCtfing Safety
DATE: 11/12/2014 • APPLICANT
• JURIS.
JURISDICTION: City of Carlsbad • PLAN REVIEWER
• FILE
PLAN CHECK NO.: 14-2985 SET: I
PROJECT ADDRESS: 2735 Palomar Airport Rd.
PROJECT NAME: Pool & Spa for Staybridge Suites
XI The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
I I The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
I I The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
I I The applicant's copy of the check list has been sent to:
EsGil Corporation staff did not advise the applicant that the plan check has been completed.
I I EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted: (by: ) Email:
Mail Telephone Fax In Person
^ REMARKS: pool & spa only
By: David Yao Enclosures:
EsGil Corporation
• GA • EJ • MB • PC 11/3
9320 Chesapeake Drive, Suite 208 • San Diego, Califomia 92123 • (858) 560-1468 • Fax (858) 560-1576
City of Carlsbad 14-2985
11/12/2014
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Carlsbad PLAN CHECK NO.: 14-2985
PREPARED BY: David Yao DATE: 11/12/2014
BUILDING ADDRESS: 2735 Palomar Airport Rd.
BUILDING OCCUPANCY:
BUILDING
PORTION
AREA
( Sq. Ft.)
Valuation
Multiplier
Reg.
Mod.
VALUE ($)
pool & spa per city 144,892
Air Conditioning
Fire Sprinklers
TOTAL VALUE 144,892
Jurisdiction Code cb By Ordinance
Bldg. Permit Fee by Ordinance • J
Plan Check Fee by Ordinance • j
Type of Review: • Complete Review
$785.81
$510.78
• Structural Only
CH Repetitive Fee
,^1 Repeats
• Other
|--| Hourly
EsGil Fee
Hr. @
$440.05
Comments:
Sheet 1 of 1
macvalue.doc +
PLAN CHECK Community & Economic
' <tk
>/- CITY OF REVIEW Development Department
1635 Faraday Avenue
CARLSBAD TRANSMITTAL Carlsbad CA 92008
w/ww.carlsbadca.gov
DATE: 11/7/2014 PROJECT NAME: Staybridge Suites
PLAN CHECK NO: CB142985 SET#:1 ADDRESS: 2735 Palomar Airport Rd
VALUATION:$ 144,892 SCOPE OF WORK:
Pool and Spa
PROJECT ID:
APN: 213-262-11
/ This plan check review is complete and has been APPROVED by:
LAND DEVELOPMENT ENGINEERING DIVISION
Final Inspection by the CM&I division is required: Yes X No
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 Comments have been sent to: iisa@aquatictechnoiogies.com
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
X Dale Willis
760-602-2784
Dale.Willls@carlsbadca.gov
Remarks:
CB142985 Staybridge Suites
Outstanding issues will be marked with'X.
Items that conform to permit requirements are inarlied
with / ^or- have intentionally been left blank.
1. SITE PLAN
Provide a fully dimensioned site plan drawn to scale. Show:
/ North arrow
/ Existing & proposed structures
• Property line dimensions
Easements
Show on site plan:
/ Drainage patterns
Existing & proposed slopes
Existing topography
Retaining Walls (location and height)
/ Indicate what will happen with soil excavated from pool area.
Include on title sheet:
/ Site address
/ Assessor's parcel number
/ Legal description/lot number
Grading: Quantities of
Cut Fill Import Export
Project does not comply with the following engineering conditions of approval
for project no:
Conditions were complies with by: Date:
Lot/Map No.: i/i5630
Subdivision/Tract: MS 12 -02 / ALPS INNOVATION HOTELS
Reference No(s): DWG 478-3A, sh 4
E-37 Page 2 of 4 REV 6/2012
CB142985 Staybridge Suites
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 information must be included on the plans. If no grading is proposed
write: "NO GRADING"
Minor Grading Permit required. NOTE: The grading permit must be issued and grading
approval obtained prior to issuance of a buildinq permit. A separate grading plan prepared a
registered civil engineer must be submitted together with the completed application form attached.
/ No grading permit required.
3. MISCELLANEOUS PERMITS
• RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work
adjacent to the public right-of-way.
A separate right-of-way issued by the engineering division is required for the following:
Please complete attached right-of-way application form and return to the engineering
department together with the requirements on the attached right-of-way checklist, at
the time of resubmittal.
Right-of-way permit and pool permit will be issued simultaneously.
E-37 Page 3 of 4 REV 6/2012
CB142985 Staybridge Suites
4. STORM WATER
Construction Compliance
/ Project Threat Assessment Form complete.
Enclosed Project Threat Assessment Form incomplete.
/ Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form
and return (SW wosse )
Requires Tier 2 Storm Water Pollution Prevention Plan. Requires submittal of Tier 2
SWPPP, payment of processing fee and review by city.
Post-Development (SUSMP) Compliance
/ Storm Water Standards Questionnaire complete.
Storm Water Standards Questionnaire incomplete. Please make the corrections, re-sign
the questionnaire and resubmit with next submittal.
Project is subject to Standard Storm Water Requirements. See city Standard Urban
Storm Water Management Plan (SUSMP) for reference.
http:/7www.carlsbadca.qov/business/buildinq/Documents/EnqStandsw-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
Other:
Attachments: Engineering Application Storm Water Form Right-of-Way Appllcation/lnfo Reference Documents
E-37 Page 4 of 4 REV 6/01/12
CITY OF
CARLSBAD
STORM WATER
COMPLIANCE
ASSESSMENT
B-24
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
am applying to the City of Carlsbad for tlie following type(s) of construction permit:
Building Permit • Riglit-of-Way Permit
• My project is categorically EXEMPT from
the requirement to prepare a storm water
pollution prevention plan (SWPPP) because it
only requires issuance of one or more of the
following permit types:
Electrical
Fire Additional
Fire Alarm
Fixed Systems
Mechanical
Mobile Home
Plumbing
Patio/Deck
Photo Voltaic
Re-Roofing
Sign
Spa-Factory
Sprinkler
Water Discharge
Project Storm Water Threat Assessment Criteria"
No Threat Assessment Criteria
• My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because
it meets the "no threat" assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier
Level. My project does not meet any of the High, Moderate or Low Threat criteria described below.
Tier 2 -
•
r/er3 •
•
Low Tiireat Assessment Criteria
My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project
meets one or more ofthe following criteria:
• Results in some soil disturbance; and/or
• Includes outdoor construction activities (such as saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling).
Moderate Tiireat Assessment Criteria
My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more ofthe following criteria:
• Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 ofthe Carlsbad Municipal Code); or,
• Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement
removal, equipment storage, refueling and maintenance areas and project meets one or more 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 April 30).
Significant Tiireat Assessment Criteria
My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any
associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas: and/or
My project is part of a phased development plan that will cumulatively result in soil disturbance totaling one or more acres including any
associated construction staging, equipment storage, refueling and maintenance areas: or.
My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant
potential for contributing pollutants to nearby receiving waters by way of storm water runoff or non-storm water discharge(s).
/ certify to tiie best of my knowledge tiiat tiie above
c/iec/ced statements are true and correct I understand
and acknowledge tiiat even tiiougfi ttiis project does
not require preparation of a construction SWPP, I must
still adhere to, and at ail times during construction
activities for the permit type(s) check above comply
with the storm water best management practices
pursuant to Title 15 ofthe Carlsbad Municipal Code
and to City Standards.
*The City Engineer may authorize minor variances from the Storm
Water Threat Assessment Criteria in special circumstances where it
can be shown that a lesser or higher Construction SWPPP Tier Level is
warranted.
Project Address: Assessor Parcel No.
Owner/Owner's A«thorized Agent Name:
OwnirjOwner's Authorized Agent Signature: A Date:lj ,
City C«f!currence: L By: V Date:
IM ONO ~:> ^^yn^
Project ID: ^
B-24 Page 1 of 1 Rev.03/09
CITY OF
CONSTRUCTION THREAT
ASSESSMENT WORKSHEET FOR
DETERMINATION OF PROJECT'S
PERCEIVED THREAT TO
STORM WATER QUALITY
E-33
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
Construction
SWPPP Tier
Level
Construction Threat Assessment Criteria* -\
Perceived
Threat to
Storm Water
Quality
Tier 3
Tier 3 - Hiah Construction Threat Assessment Criteria /
• Project site is 50 acres or more and grading will occur during the rainy season
• Project site is 1 acre or more in size and is located within the Buena VistaAr Agua Hedionda
Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or
discharges directly to an ESA /
• Soil at site is moderately to highly erosive (defined as having a predominance of soils with
USDA-NRCS Erosion factors kf greater than or equal to 0.4) /
• Site slope is 5 to 1 or steeper /
• Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1
through April 30). /
• Owner/contractor received a Storm Water Notice of Violation v^in past two years
High
Tier 3
Tier 3 - Medium Construction Threat Assessment Criteria / Medium
Tier 3
• All projects not meeting Tier 3 High Construction Threat As^ssment Criteria Medium
Tier 2
Tier 2 Hiqh Construction Threat Assessment Criteria /
• Project is located within the Buena Vista or Agua Medionda Lagoon watershed, inside or
within 200 feet of an environmentally sensitive areafESA) or discharges directly to an ESA
• Soil at site Is moderately to highly erosive (defined as having a predominance of soils with
USDA-NRCS Erosion factors kf greater than coequal to 0.4)
• Site slope is 5 to 1 or steeper /
• Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1
through April 30). /
• Owner/contractor received a Storm Wzfter Notice of Violation within past two years
• Site results in one half acre or mor^f soil disturbance
High
Tier 2
Tier 2 - Medium Construction Threat A^essment Criteria Medium
Tier 2
• All projects not meeting Tier 2/l4igh Construction Threat Assessment Criteria Medium
Tier 1
Tier 1 - Medium Inspection Threar Assessment Criteria
Medium
Tier 1
• Project is located withij/the Buena Vista or Agua Hedionda Lagoon watershed, within or
directly adjacent to aryenvironmentally sensitive area (ESA) or discharges directly to an ESA
• Soil at site is mod^tely to highly erosive (defined as having a predominance of soils with
USDA-NRCS Era&on factors kf greater than or equal to 0.4)
• Site slope is 5/fo 1 or steeper
• Constructiof/is initiated during the rainy season or will extend into the rainy season (Oct 1
through AfJril 30).
• Owner^ntractor received a Storm Water Notice of Violation within past two years
• Sit^/^^sults in one half acre or more of soil disturbance
Medium
Tier 1
Tier 1 - Low Inspection Threat Assessment Criteria
• All projects not meeting Tier 1 Medium Construction Threat Assessment Criteria Low
Exempt - Not Applicable -Exempt
*The city engineer may authorize minor variances from the construction threat assessment criteria in special circumstances
where it can be shown that a lesser or higher amount of storm water compliance inspection is warranted in the opinion of
the city engineer
E-33 Page 1 of 1 REV 4/30/10
CITY OF
ARI SRAD
STORM WATER
STANDARDS
QUESTIONNAIRE
E-34
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
STEP 2
TO BE COMPLETED FOR ALL NEW OR REDEVELOPMENT PROJECTS
To determine if your project is a priority development project, please answer the following questions: YES N 0
1. Is your project a new development that creates 10,000 square feet or more of impervious surfaces collectively
over the entire project site? This includes commercial, Industrial, residential, mixed-use, and public
development projects on public or private land.
2. Is your project creating or replacing 5,000 square feet or more of impervious surface collectively over the entire
project site on an existing site of 10,000 square feet or more of impervious surface? This includes commercial,
industrial, residential, mixed-use, and public development projects on public or private land.
3. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a restaurant? A restaurant is a facility that sells prepared
foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared
foods and drinks for immediate consumption.
4. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a hillside development project? A hillside development
project includes development on any natural slope that is twenty-five percent or greater
5. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface
collectively over the entire project site and supports a 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 5,000 square feet 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 transportation of
automobiles, trucks, motorcycles, and other vehicles.
7. Is your project a new or redevelopment project that creates or replaces 2,500 square feet or more of
impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive
Area (ESA)? "Discharging Directly to" includes flow that Is conveyed 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
project to the ESA (i.e. not commingles with flows from adjacent lands).*
8. Is your project a new development that supports an automotive repair shop? An automotive repair shop is a
facility that is categorized in any one of the following Standard Industrial Classification (SIC) codes: 5013,
5014, 5541, 7532-7534, or 7536-7539.
9. Is your project a new development that supports a retail gasoline outlet (RGO)? This category includes RGO's
that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily Traffic (ADT) of
100 or more vehicles per day.
10. 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?
11.1s 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%? /
If you answered "yes" to one or more of the above questions, you ARE a priority development project and are therefore sub
implementing structural Best Management Practices (BMP's) In addition to implementing Standard Storm Water Requirement;
as source control and low impact development BMP's. A Storm Water Management Plan (SWMP) must be submitted witi
application(s) for development. Go to step 3 for redevelopment projects. For new projects, go to step 4 at the end o
questionnaire, check the "my project meets PDP requirements" box and complete applicant information.
ect to
> such
1 your
f this
If you answered "no" to all of the above questions, you ARE NOT a priority development project and are therefore subject to
implementing only Standard Storm Water Requirements such as source control and low impact development BMP's required for all
development projects. A Storm Water Management Plan (SWMP) is not required with your application(s) for development. Go to step
4 at the end of this questionnaire, check the "my project does not meet PDP requirements" box and complete applicant
information.
E-34 Page 2 of 3 Effective 6/27/13
CITY OF
CARI SBAD
STORM WATER
STANDARDS
QUESTIONNAIRE
E-34
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
INSTRUCTIONS:
To address post-development pollutants that may be generated from development projects, the City requires that new development and
significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMP's) into the project
design per the City's Standard Urban Stormwater Management Plan (SUSMP). To view the SUSMP, refer to the Engineering Standards
(Volume 4, Chapter 2) at www.carlsbadca.aov/standards.
Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision,
discretionary permits and/or 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 Stormwater Requirements' or be subject to additional criteria called 'Priority Development Project Requirements'. Many
aspects of project site design are dependent upon the storm water standards applied to a project.
Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has
responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire
was incorrectly filled out and is subject to more stringent 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 separate completed and signed questionnaire must be submitted for each new development application submission. Only one
completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently.
In addition to this questionnaire, you must also complete, sign and submit a Project Threat Assessment Form with construction permits
for the project.
Please start by completing Step 1 and follow the Instructions. When completed, sign the form at the end and submit this with your
application to the city.
STEP 1
TO BE COMPLETED FOR ALL PROJECTS
To determine if your project is a priority development project, please answer the following questions:
YES NO
f
1. Is your project LIMITED TO constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet
the following criteria: (1) Designed and constructed to direct storm water runoff to adjacent vegetated areas, or
other non-erodible permeable areas; OR (2) designed and constructed to be hydraulically disconnected from
paved streets or roads; OR (3) designed and constructed with permeable pavements or surfaces in
accordance with USEPA Green Streets guidance?
2. Is your project LIMITED TO retrofitting or redeveloping existing paved alleys, streets, or roads that are
designed and constructed in accordance with the USEPA Green Streets guidance?
If you answered "yes" to one or more of the above questions, then your project is NOT a priority development project and therefore is
NOT subject to the storm water criteria required for priority development projects. Go to step 4, mark the last box stating "my
project does not meet PDP requirements" and complete applicant information.
If you answered "no" to both questions, then go to Step 2.
E-34 Page 1 of 3 Effective 6/27/13
STORM WATER Development Services
Land Development Engineering STANDARDS Development Services
Land Development Engineering
^ CITY OF QUESTIONNAIRE
E-34
1635 Faraday Avenue
760-602-2750
CARLSBAD
QUESTIONNAIRE
E-34 www.carlsbadca.gov
STEP 3
TO BE COMPLETED FOR REDEVELOPMENT PROJECTS THAT ARE PRIORITY DEVELOPEMENT PROJECTS ONLY Complete the questions below regarding your redevelopment project: YES MO
Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than
50% ofthe surface area ofthe previously existing development?
If you answered "yes," the structural BMP's required for Priority Development Projects apply only to the creation or replacement of '
impervious surface and not the entire development. Go to step 4, check the "my project meets PDP requirements" box and
complete applicant information.
If you answered "no," the structural BMP's required for Priority Development Projects apply to the entire development. Go to step 4,
check the "my project meets PDP requirements" box and complete applicant information.
STEP 4
CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT INFORMATION
My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater
criteria per the SUSMP and I understand 1 must prepare a Storm Water Management Plan for submittal at time of application.
I understand flow control (hydromodification) requirements may apply to my project. Refer to SUSMP for details.
My project does not meet PDP requirements and must only comply with STANDARD STORMWATER REQUIREMENTS per
the SUSMP. As part of these requirements, I will incorporate low impact development strategies throughout my project.
Applicant Information and Signature Box
Accessor's Parcel Number(s):
Atfiplicant Ti
Applicant Siojiature: t Dat
This Box for City Use Only
City Concurrence:
By:
Date^'
Project I
* 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 forthe San Diego Basin (1994) and amendments); areas designated as preserves or their
quivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent
environmentally sensitive areas which have been identified by the Copermittees.
E-34 Page 3 of 3 Effective 6/27/13
^55^ CITY OF
CARLSBAD
STORM WATER COMPLIANCE FORM
TIER 1 CONSTRUCTION SWPPP
E-29
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
STORM WATER COMPLIANCE CERTIFICATE
My project is not in a category of permit types exempt from the Construction
SWPPP requirements
^ My project is not located inside or within 200 feet of an environmentally
sensitive area with a significant potential for contributing pollutants to nearby
receiving waters by way of storm water runoff or non-storm water
discharge(s).
My project does not require a grading plan pursuant to the Carlsbad
Grading Ordinance (Chapter 15.16 ofthe Carlsbad Municipal Code)
My project will not 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 that meets
one or more ofthe additional following criteria:
• located within 200 feet of an environmentally sensitive area or the
Pacific Ocean; and/or,
• disturbed area is located on a slope with a grade at or exceeding 5
horizontal to 1 vertical; and/or
• disturbed area is located along or within 30 feet of a storm drain inlet, an
open drainage channel or watercourse; and/or
• construction will be initiated during the rainy season or will extend into
the rainy season (Oct. 1 through April 30).
I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT ALL OF THE ABOVE
CHECKED STATEMENTS ARE TRUE AND CORRECT. I AM SUBMITTING
FOR CITY APPROVAL A TIER 1 CONSTRUCTION SWPPP PREPARED IN
ACCORDANCE WITH THE REQUIREMENTS OF CITY STANDARDS.
I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST
MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES
TO THE MAXIMUM EXTENT PRACTICABLE TO MINIMIZE THE
MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO MINIMIZE
THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED
POLLUTANTS; AND, (2) ADHERE TO, AND AT ALL TIMES, COMPLY WITH
THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP THROUGHOUT THE
DURATION OF THE CONSTRUCTION ACTIVITIES UNTIL THE
CONSTRUCTION WORK IS COMPLETE AND APPROVED BY THE CITY OF
CARLSBAD.
3WNER'S AGENT NAI^ (PRINT)
STORM WATER POLLUTION PREVENTION NOTES
1. ALL NECESSARY EQUIPMENT AND MATERIALS
SHALL BE AVAILABLE ON SITE TO FACILITATE
RAPID INSTALLATION OF EROSION AND
SEDIMENT CONTROL BMPS WHEN RAIN IS
EMINENT.
2. THE OWNER/CONTRACTOR SHALL RESTORE
ALL EROSION CONTROL DEVICES TO
WORKING ORDER TO THE SATISFACTION OF
THE CITY ENGINEER AFTER EACH RUN-OFF
PRODUCING RAINFALL.
3. THE OWNER/CONTRACTOR SHALL INSTALL
ADDITIONAL EROSION CONTROL MEASURES
AS MAY BE REQUIRED BY THE CITY
ENGINEERING OR BUILDING INSPECTOR DUE
TO UNCOMPLETED GRADING OPERATIONS OR
UNFORESEEN CIRCUMSTANCES WHICH MAY
ARISE.
4. ALL REMOVABLE PROTECTIVE DEVICES SHALL
BE IN PLACE AT THE END OF EACH WORKING
DAY WHEN THE FIVE (5) DAY RAIN
PROBABILITY FORECAST EXCEEDS FORTY
PERCENT (40%). SILT AND OTHER DEBRIS
SHALL BE REMOVED AFTER EACH RAINFALL.
5. ALL GRAVEL BAGS SHALL BE BURLAP TYPE
WITH 3/4 INCH MINIMUM AGGREGATE.
6. ADEQUATE EROSION AND SEDIMENT
CONTROL AND PERIMETER PROTECTION BEST
MANAGEMENT PRACTICE MEASURES MUST BE
INSTALLED AND MAINTAINED.
SPECIAL NOTES
PROJECT INFORMATION
Site Address ^735 la\tmr
Assessor's Parcel Number:
Project ID: (^^^^
Construction Permit No.r^—?o--^
Estimated Construction Start Date
Project Duration Months
Emergency Contact:
(Name:
Perceived Threat to Storm Water Quality
^^^S'^edium
O Low
If medium box is checked, must attach a site plan
sheet showing proposed work area and location
of proposed structural BMPs
For City Use Only
CITY OF CARLSBAD
STANDARD TIER 1 SWPPP
Approved B\A
Date:
E-29 Page 1 of 3 REV 4/30/10
Erosion Control
BMPs Sediment Control BMPs
Tracking
Control
BMPs
Non-Storm Water
Management BMPs
Waste Management and Materials
Poilution Control BMPs
Best Management Practice
(BMP) Description -> Geotextiles & Mats Wood Mulching Earth Dikes and Drainage Swales Slope Drains Silt Fence Sediment Trap Check Dam Fiber Rolls Gravel Bag Berm Street Sweeping and Vacuuming Sandbag Barrier Storm Drain Inlet Protection Stabilized Construction Ingress/Egress Stabilized Construction Roadway Water Conservation Practices Paving and Grinding Ooerations Potable Water/Irrigation Vehicle and Equipment Cleanina Material Delivery and Stnrane Material Use Stockpile Management Spill Prevention and Cnntrnl Solid Waste Manaaement Hazardous Waste Mananpmfint Concrete Waste Manaaement CASQA Designation
Construction Activity EC-7 EC-8 EC-9 EC-11 SE-1 SE-3 SE-4 SE-5 SE-6 SE-7 SE-8 SE-10 TR-1 TR-2 NS-1 NS-3 NS-7 NS-8 WM-1 WM-2 WM-3 WM-4 WM-5 WM-6 WM-8 Grading/Soil Disturbance
Trenching/Excavation >< X
Stockpiling
Drilling/Boring
Concrete/Asphalt Saw
cutting
Concrete flatwork
Paving
Conduit/Pipe Installation
Stucco/Mortar Work
Waste Disposal
Staging/Lay Down Area
Equipment Maintenance
and Fueling
Hazardous Substance
Use/Storage
Dewatering
Site Access Across Dirt
Other (list):
Instructions: Begin by reviewing the list of construction activities and checking the box to the left of any activity that will occur during the proposed construction. Add any other activity descriptions in the
blank activity description boxes provided for that purpose and place a check in the box immediately to the left of the added activity description. For each activity descrribed, pick one or more best
management practices (BMPs) from the list located along the top of the form. Then place an X in the box at the place v*ere the activity row intersects with the BMP column. Do this for each activity that was
checked off and for each of the selected BMPs selected from the list. For Example - If the project includes site access across dirt, then check the box to the left of "Site Access Across Dirt". Then review
the list for something that applies such as "Stabilized Construction Ingress/Egress" under Tracking Control. Follow along the "Site Access Across Dirt" row until you get to the "Stabilized Construction
Ingress/Egress" column and place an X in the box where the two meet. As another example say the project included a stockpile that you intend to cover writh a plastic sheet. Since plastic sheeting is not on
the list of BMPs, then write in "Cover with Plastic" in the blank column under the heading Erosion Control BMPs. Then place an X in the box where the "Stockpiling" row intersects the new "Cover virith
Plastic" column.
To learn more about w/hat each BMP description means, you may wish to review the BMP Reference Handout prepared to assist applicants in the selection of appropriate Best Management Practice
measures. The reference also explains the California Stonnwater Quality Association (CASQA) designation and how to apply the various selected BMPs to a project.
E-29 Page 2 of 3 REV 4/30/10
<^^f''
^ CITY OF
CARLSBAD
PLANNING DIVISION
BUlLDiNG PLAN CHECK
APPROVAL
P-29
Development Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www/.carl.sbadca.eov
DATE: November 13, 2014 PROJECT NAME: Staybridge Suites PROJECT ID: CUP 12-05
PLAN CHECK NO: 1 SET#: 1 ADDRESS: 2735 Palomar Airport Road APN: 213-262-11
3 This plan check review is complete and has been APPROVED by the Planning
Division.
By: Jason Goff, Associate Planner (^«^
A Final Inspection by the Planning Division is required • Yes |^ No
you may also have corrections from one or more of the divisions listed beiow. Approval
from these divisions may be required prior to the issuance of a building permit.
Resubmitted plans should include corrections from aii divisions.
Q 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: lisa@aauatictechnologies.com
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
1 1 Chris Sexton
760-602-4624
Ch ris.Sexton@carlsbadca .gov
1 1 Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.gov
1 1 Greg Ryan
760-602-4663
Gregorv.Rvan@carlsbadca.gov
1 1 Gina Ruiz
760-602-4675
Gina.Ruiz@carlsbadca.gov
1 1 Linda Ontiveros
760-602-2773
Linda.Ontiveros@carlsbadca.gov
Q Cindy Wong
760-602-4662
Cvnthia.Wong@carlsbadca.gov
X Jason Goff
760-602-4643
Jason.Goff@carlsbadca.gov
• 1 1 Dominic Fieri
760-602-4664
Dominic.Fierj@carlsbadca.gov
^^55^ CITY OF
PLAN CHECK
BliiLBii^G DEPT
(^0|ai>ity & Economic
^^55^ CITY OF REVIEW Development Department
1635 Faraday Avenue
CARLSBAD TRANSMITTAL Carlsbad CA 92008
www.carlsbadca.gov
DATE: 1V07/2014
PLAN CHECK NO: 1 SET#: 1
PROJECT NAME: STAYBRIDGE SUITES - POOL PROJECT ID: CB142985
ADDRESS: 2735 PALOMAR AIRPORT RD APN:
Kl This plan check review is complete and has been APPROVED by the FIRE Division.
By: GR
A Final Inspection by the FIRE Division is required ^ Yes • No
This plan check review is NOT COMPLETE. Items missing or incorrect are listed on
the attached checklist. Please resubmit amended plans as required.
Plan Check Comments have been sent to:
Vou may also have corrections from one or more of the divisions listed beiow. Approval
from these divisions may be required prior to the issuance of a buiiding permit
Resubmitted plans should include corrections from ali divisions.
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
1 1 Chris Sexton
760-602-4624
Chrls.Sexton@carlsbadca.eov
1 1 Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.gov
X Greg Ryan
760-602-4663
Gregorv.Rvan@carlsbadca.gov
1 1 Gina Ruiz
760-602-4675
Gina.Ruiz@carlsbadca.gov
1 1 Linda Ontiveros
760-602-2773
Linda.Ontiveros@carlsbadca.gov
Q Cindy Wong
760-602-4662
Cynthia.Wong@carlsbadca.gov
1 1 Dominic Fieri
760-602-4664
Dominic.Fieri@carlsbadca.gov
Carlsbad Fire Department IUIL0PC3 DEI
COPY
Plan Review
Date of Report:
Requirements Category: Tl, INDUST
11-07-2014 Reviewed by:
Name:
Address:
AQUATIC TECHNOLOGIES
LISA ZOSCAK
32232 PASEO ADELANTO
SUITE A
SAN JUAN CAPISTRANO, CA
92675
Permit #: CB142985
Job Name:
Job Address:
STAYBRIDGE SUITES -POOL
2735 PALOMAR AIRPORT RD
Please review carefully all comments attached.
Conditions:
CITY OF CARLSBAD FIRE DEPARTMENT - APPROVED: w/REQUIREMENTS
THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN
CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW.
1. Please provide a KNOX Key Box at each pool enclosure gate and at the entrance to the pool equipment pad.
Entry: 11/07/2014 By: GR Action: AP
Count? of ^an Biego
DEPARTMENT OF ENVIRONMENTAL HEALTH
FOOD AND HOUSING DIVISION
ELIZABETH P0ZZE80N PUN CHECK AND CONSTRUCTION AMY HARBERT
DIRECTOR P.O. BOX 129261, SAN DIEGO, CA 921 1 2-9261 ASSISTANT DIRECTOR
(858)50S-6660 FAX (858)505-6848
www.5dcdeh.orQ
POOL PLAN APPROVAL SHEET
DBA: STAYBRIDGE SUITES October 28, 2014
SITE: 2735 PALOMAR AIRPORT RD CARLSBAD PC #: FPOOL-
000626
BUSINESS OWNER: SAA
Plans are approved contingent upon the following:
1) Department of Environmental Health (DEH) stamped plans shall be maintained at the jobsite
and be available for review at the time of the Inspection.
2) Changes to the structures, appurtenances, equipment layout or application must be
submitted for approval. Changes made without approval will make the plan approval null
and void.
3) Obtain local Building Department and all applicable agencies permits and approvals.
4) All pool-related equipment shall be certified by an ANSI accredited testing agency or in the
absence of ANSI standards a nationally recognized standard will be considered.
5) Prior to pouring concrete, call (858) 505-6660 to schedule a pre-gunite inspection. Large
pools may call for plumbing inspection prior to backfilling.
6) The operational Health Permit may be applied for after the pre-gunlte inspection.
7) At the final inspection all equipment including signs, safety devices, free chlorine test kit,
first aid kit and vacuuming equipment shall be available.
8) It is recommended that a Certified Pool Operator (CPO) be responsible for the pool. Contact
the National Swimming Pool Foundation at nspf.org for listing of CPO classes.
9) For indoor pools, to ensure human comfort, to lessen the evaporation of water and to
prevent the proliferation of microorganisms, maintain the relative humidity at 40 to 60 %,
provide 6-12 air changes per hour and keep the air temperature above the pool 2-5 degrees
higher than the pool water.
10) Keys, cards or other means of access shall be made available for routine inspection by DEH
once the pool completes construction.
11) Complete AB1020 form.
12) NOTE: The owner/operator is responsible for the function, calibration, maintenance,
and testing of the safety vacuum release, suction-limiting vent, gravity drainage, or
automatic pump shut-off system. Environmental Health will not inspect the system to
determine whether it is functioning properiy, if it has been calibrated, If It Is being
properiy maintained, and wili not conduct testing of the system.
Plans reviewed by CPENN @ 858-505-6660
CALL (858) 505-6660 IN ADVANCE TO SCHEDULE PRE-GUNITE, PRE-PLASTER AND FOR FINAL INSPECTION. A
FINAL INSPECTION SHALL BE CONDUCTED AND AN ENVIRONMENTAL HEALTH PERMIT SHALL BE ISSUED PRIOR
TO OPENING AND OPERATING THIS PUBLIC POOL FACILITY.
cc: File
District Inspector jvJQV 0 S 2014
"Prevention Comes First"
PARTI
MAIN OFFICE
5500 Overland Avj
SAN DIEGO, CA
(858) 505-6660
DEPARTMENT OF ENVIRONMEJ
FOOD AND
JLICi
NORTH COUNTY
151 E.CARMELST
SAN MARCOS, CA 92078
(760)471-0730
(For office use only)>->^^y ^
PLAN CHECK #: (JQ'UCcP^i
INTAKE DATE:
AMT PAID:
CHECK#
1^
FACILITY BUSINESS AND CONTACT INFORMATION
EW/TI •RENOVATION •REMODEL •CONSULTATION •REVISION •OTHER_
,S Assessor's Parcel NO.SA,-^' S^^nA-QO Facility Name (_
Facility Address
BUSINESS OWNER:
Name
Mailing Address [g'^ S- nWU lO\
Company
Citv^amjSaZP^tate Zip^3OT^
Fax ( )_ E-Mail
DESIGNER/C
Name
TRACTOR:
E-Mail Address.
Contact Person
Contact
^.^ompany
State Contractor's License if applicable | ^ 1 "1 ^
Contact Phone
Contact E-Mail Address
Total # of Poolsat Site:
POOL FACILITY INFORMATION
Total Square Feet of Each Pool: Projected Construction Completion Date:
TVPE OF POOL (s)
Pool Spa •Wader •Xherapy/lVIedical I I Interactive Water Feature ! I Competition
• Instructional • Spray Pad • Diving • Slide Landing Pool n Water Attraction I I Special Purpose
If Special Purpose, explain?
Indoor Pool •Ves'^ No^ Perimeter Overflow PooKs) nYeslvOlNo
MAJOR RENOVATION: changes to existing pool shell or plumbing from pool. QVes •NO- Describe_
REMODEL: for rec. bldg with sanitary facilities or water feature addition to existing pool. QVes nNo
Describe
SEWER"r^Public GSeptic/ Private WATER: •Public •Well/ Private (If private contact Land Use at (858) 565-5173)
Identify the municipal water and wastewater districtQ^lltl^Qi, Mil /1\C Stl^(h^\^)^f Ol^^jnT^jCi'
Restrooms: Are separate toilet facilities for men and women located within 100 feet of the public poolf^Yes DNO
S;@>ritARYM^ltlTES (Indicate fbr new pools, remodels and major renovations)
Number of Toilets ' Number of Urinals ! Number of Sinks ! Number of Showers
T
I
Number of Drinking Fountains
OTHER ACTIVITIES •'
rQMRMANENT COSMETICS I •BODY PIERCING I •OTBtER
•>v'JTi,'-iii''':i••--.•i^V':=A'>'- . • w^.--. . . \..-.<.^s.i-i&ii.^'...--''v'\'-k'ri>^^^^^
COMPLETE PART II
FOOD & HOUSING DIVISION-PLAN CHECK P-l
FHD-PC-178 (02/11)
PART II
2)
3)
4)
5)
6)
7)
8)
9)
FOR NEW POOL OR MAJOR RENOVATION APPLICATION.
gceived and ail fees are paid.
ft.) and done in a professional manner. The minimum
iols, three (3) sets for all other facilities,
ntractor and architect to be on plans.
SUBMIT THE FOLLOWING DOCyJ
Applications will not be processed un
1) Plans must be submitted to a stati
size is 11" X 17". A total of four (4) sets are r3
remodels and renovation.
Name, address, and telephone number of owner, pool contra(5?
Address of pool to be constructed. Include Vicinity Map for new sites
Plot plan drawn to scale showing the pool location in relation to all bwldings on'the p^fH^y. Where applicable such as for restroom
exemption, indicate the travel distance in feet from the pool to the living quarters on the property that are farthest from the pool.
Smaller scale is acceptable on the plot plan only.
Indicate equipment make and model numbers on the plans and include a complete data sheet (See document Pool Plan Checklist).
Scale floor plan of pool equipment room or area, minimum scale 'A inch = 1 foot. Identify all equipment and plumbing.
Pool user restroom, dressing and shower facilities plan (when necessary). If restroom, dressing and shower facilities are required or
proposed. (See document Pool Ancillary Facilities Checklist).
Pool decking, pool fencing or enclosure plans. Existing facilities must be clearly defined.
Exhaust ventilation plans to be included for indoor pools.
10) Identify all structures and features within the pool enclosure area.
•Municipal/County Agency
•government Facility
•_Resort/Conyention Center_
_ClAP.E^-!P.??L'Q9.'?,P]?i'^?:?n!^l.
T'S PE OF 0PER.4T10N (check all that apply)
•Carnpground
•Coujitty Club/Private Club
•YMCA/YWCA/Boys & Girls Club
•Health Club/Swim Club
•Bed and Breakfast
13 Waterpark/Tbeme Park
JCollege or University
•Publk/PrivateSchoo
•Common Interest Development
•other:
FOR pool MINOR RENOVATION CHECK TYPE:
• Resurfacing the pool interior - Describe type of finish and color of pool interior. Include plan top view with dimensions, fixtures
including split drain detail as applicable.
•The enclosure - Submit elevations and details of the fence and gates and a site plan showing the location of the new fence.
• Removal and replacement ofthe deck - Submit a deck plan and fully describe scope of all work to be done including drainage.
• Equipment Change - See Part III.
I declare under penalty of perjury that to the best of my knowledge and belief, the description of use and information contained on this application and
plans are correct and true. I hereby consent to all necessary inspections made pursuant to law and incidental to the issuance of this review and the
operation of this business. I also agree to conform to all conditions, orders, and directions, issued pursuant to the California Health and Safety Code, and
all applicable County and City Ordinances. I understand that if the plans are incomplete due to a lack of any of the required information, the plans will be
rejected and upon resubmission, a plan recheck fee will be charged. I am aware that plan check fees are not fully refundable and that plans, once
reviewed, will be picked up within 60 days or they will be discarded. Plans are valid for one year after stamp. Any changes to the released documents
.,>yj'!L!?.?..?."..''.!™5?.4.?^^^^^ Health.
OTHER AGENCIES: • BLDG DEPARTMENT • FIRE DEPARTMENT O WATERAVASTEWATER DISTRICTS • DEH-LWQ O DEH-HAZMAT
(NOTE: If you are the business owner and an honorably discharged veteran you may be eligible for a fee exemption).
(For office use only)
PLAN CHECK #/TYPE:_
ASSIGNED TO: -
PERMIT NUMBER/TYPE: GEMSyS TRACT:
PLAN STATUS: nAPPROXf
RECHECK STATU:
SVED^BLUE TAG; PC fNITIALS
PUTECGDE:
REVIEW DATE
•ROVEDHn^ISAPPROVED^BLUE TAG; PC INITIALS RECHECK DATE
DATEARgRDVED
I'LETE PART HI EOR EQl IPMENT CHANGES ONI A
FOOD & HOUSING DIVISION-PLAN CHECK
FHD-PC-178 (02/11) P-2
CB142985 2735 PALOMAR AIRPORT RD
STAYBRIDGE HOTEL
/0/3i//cf
Final Inspection required by:
• Plan • CM&I • Fire •
SW |4 -39)^ aissuED acv.
Approved D^te By
BUILDING
PLANNING
ENGINEERING
FIRE Expedite? V N
DIGfTAL FILES Required? Y N
HazMat
APCD
Health
Forms/Fees sent Rec'd Due? By
Encina V N
Fire Y N
HazHealthAPCD Y N
PE&M Y N
School Y N
Sewer Y N
Stormwater Y N
Special Inspection Y N
CFD. Y N
LandUse: Density: ImpArea: FY: Annex: Factor:
PFF: Y N
Comments Date Date Date Oate
Building
Planning
Engineering
Fire
Need?
• Done
• Done
• Done
• Done