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HomeMy WebLinkAbout2815 JEFFERSON ST; 301; CB053457; Permit12-19-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB053457 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: 2815 JEFFERSON ST CBAD St: 301 Tl Sub Type: INDUST 2031102900 Lot#: 0 $26,180.00 Construction Type: NEW Reference #: KENT JESSEE-748 SF SHELL TO OFFICE Applicant: SMITH CONSULTING Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Plan Check*: Owner: BICAJESSEE ADVENTURES L L C 2075 CORTE DEL NOGAL #S CARLSBAD CA 92011 ISSUED 09/30/2005 RMA 12/19/2005 12/19/2005 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee $226.31 Meter Size $0.00 Add'l Reel, Water Con, Fee $147.10 Meter Fee $0.00 SDCWA Fee $0.00 CFD Payoff Fee $5.50 PFF (3105540) $0.00 PFF (4305540) $0.00 License Tax (3104193} $0.00 License Tax (4304193) $0.00 Traffic Impact Fee (3105541) $0.00 Traffic Impact Fee (4305541) $0.00 PLUMBING TOTAL $0.00 ELECTRICAL TOTAL $0.00 MECHANICAL TOTAL $0.00 Master Drainage Fee Sewer Fee $0.00 Redev Parking Fee $0.00 Additional Fees TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $476.48 $439.82 $0.00 $0.00 $0.00 $0.00 $41.00 $60.00 $24.00 $0.00 $0.00 $0.00 $0.00 $1,420.21 Total Fees:$1,420.21 Total Payments To Date:$1,420.21 Balance Due:$0.00 BUILDING PLANS I/IN STORAGE ATTACHED Inspector: FINAL APBROVAL Date: _J Clearance: NOTICE: Please take NOTIC0fhat approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 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 otheiwise expired. 0527301-i 0074 09/30/2005 001 11 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 ?t. paaaeei PLAN CHECK NO. EST. VAL. nt / f /9 S Plan Ck. Deposit Validated Bj Date Busine nw-~LotN°.Subdivision Name/Number Unit No. Phase No. Total # of units # of Bathrooms •nploant) Name Address IS. ABffilGAHT Q Conwaotor Q Agetm^oHSjomcaoter D'^hwnar City State/Zip Telephone # Fax # (Sec. 7031.5 Business and Professions Code: Any Cfty 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 tha^olleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$800]),- - Name State License # Address License Class B-l City State/Zip City Business License * _Z.jLl_ Telephone # (Address City TelephoneDesigner Name State License # e. WORKERS* Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. *fjQ^ 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: , O __ Expiration Date / //Insurance Company Policy No. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 14100] OR LESS) Q 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 shaB subject an employer to criminal penalties and cMI fines up to one hundred thousand dollars (4100,000), in addition to the coat of compensation, damages as provided for hi Section 3706 of the Labor coda. Interest and attorney's faaa. SIGNATURE __ DATE _ __ •?. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q I. as owner of the property or my employees wfth 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 ye« of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). Q 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). Q 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. D YES QNO 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. ! plan to provlda 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) the following persons to provide the work indicated (include name / address / phone number / type of work): _ ___ PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant reqijiara to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 2E533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? G YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES Q 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. 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 NAMELENDER'S ADDRESS. I certify that f 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 above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, OSHA: An OSHA permit is reouired for excavations over 5'0* deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permrt/ssuWl by the building Official under the provisions of this Code shall expire by limitation and become null and void If the building or work f such permit or If the building or work authorized by sych permit is suspended or abandonedauthorized by such permit is, at any time after the work \ APPLICANT'S SIGNATURi 106.4.4 Uniform Building Code). DATE PINK: Finance Gfty it Carlsbad Final Building Inspection Dept: Building Engineering Planning CMWD St Lite Plan Check #: Permits: CB053457 Project Name: KENT JESSEE-748 SF SHELL TO OFFICE Address: 2815 JEFFERSON ST #301 Lot: Contact Person: DAVE Phone: 6194381962 Sewer Dist: CA Water Dist: CA fUsrwJ.U , i Date: 06/13/2006 Permit Type: Tl Subtype: INDUST 0 Inspected By: Inspected By: Inspected By: Date Inspected: Date Inspected: Date Inspected: Approved :-^v Disapproved: Approved: Approved: Disapproved: Disapproved: Comments: City of Carlsbad Bldg Inspection Request For: 06/13/2006 Permit* CB053457 Title: KENT JESSEE-748 SF SHELL TO Description: OFFICE Sub Type: INDUST Inspector Assignment: TP 2815 JEFFERSON ST 301 Lot 0 Type: Tl Job Address: Suite: Location: APPLICANT SMITH CONSULTING Owner: BICAJESSEE ADVENTURES L L C Remarks: Phone: 6194381962 Inspector: Total Time:Requested By: DAVE Entered By: CHRISTINE CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Act Comment Comments/Notices/Hold Associated PCRs/CVs Original PC# Date 05/23/2006 05/23/2006 05/23/2006 05/05/2006 05/05/2006 04/18/2006 04/17/2006 04/11/2006 04/1 1/2006 03/15/2006 03/15/2006 Inspection History Description 14 34 44 17 18 17 17 14 34 34 44 Frame/Steel/Bolting A/Veld ing Rough Electric Rough/Ducts/Dampers Interior Lath/Dry wall Exterior Lath/Drywall Interior Lath/Drywall Interior Lath/Drywall Frame/Steel/Bo Iting/Welding Rough Electric Rough Electric Rough/Ducts/Dampers Act AP AP AP AP we PA CO AP AP NR NR Insp TP TP TP PY PY TP TP PY PY TP TP Comments T-CEIL CEIL LITES DUCTS N/INCL CORR WALLS BLDG. LOCKED ^•••i^^ EsGil Corporation In <Partnersnip -with government for (BuiGfing Safety DATE: 10/15/05 JURISDICTION: City of Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO.: 05-3457 SET: I PROJECT ADDRESS: 2815 Jefferson Street Suite 301 PROJECT NAME: W. Kent Jessee and Associates Suite 301 - TI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. X] The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: Smith Consulting Architects /Andrew Tarango 12220 El Camino Real Suite 200, San Diego, CA 92130 Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgi! Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Andrew Tarango w.ft\ Telephone #: 858-793-4777 Date coSaSe^/a-/?.^- (by: /W) Fax #: 858-793-4787 Mail Telephone **s Fax */ In Person REMARKS: By: Doug Moody Enclosures: Esgil Corporation D GA D MB D EJ D PC 10/4/05 tmsmtl.dot 9320 Chesapeake Drive, Suite 208 * San Diego, California 92123 + (858)560-1468 4 Fax (858) 560-1576 City of Carlsbad O5-3457 10/15/05 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: 05-3457 OCCUPANCY: B TYPE OF CONSTRUCTION: V1H ALLOWABLE FLOOR AREA: SPRINKLERS?: Unknown REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 9/30/05 DATE INITIAL PLAN REVIEW COMPLETED: 10/15/05 JURISDICTION: City of Carlsbad USE: Office ACTUAL AREA: 735sf STORIES: 3 HEIGHT: OCCUPANT LOAD: 7 DATE PLANS RECEIVED BY • ESGIL CORPORATION: 10/4/05 PLAN REVIEWER: Doug Moody FOREWORD (PLEASE READ): 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 ordinances enforced 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. Code sections cited are based on the 1997 UBC. 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, 1997 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. TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC)tiforw.dot City of Carlsbad 05-3457 1O/15/05 Please make all corrections on the original tracings, as requested in the correction list. Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. 1. Provide a statement on the Title Sheet of the plans stating that this project shall comply with the 2001 edition of the California Building Code (Title 24), which adopts the 1997 UBC, 2000 UMC, 2000 UPC and the 2002 NEC. 2. Provide a fully dimensioned floor plan showing the size and use of all rooms or areas within the space being improved or altered. Draw the plans to scale and indicate the scale on the plan. Section 106.3.3. 3. Please revise the section view of the new interior partitions wall types 2 and 3. Show: a) Please show for wall types 2 and 3, type, size and spacing of studs. Indicate gauge for metal studs. Specify manufacturer and approval number or indicate "to be ICBO approved". b) Please show for wall types 3 the method of attaching top plates to structure. (Please revise the spacing of the studs used for lateral bracing to 4' or provide calculations to show the 8' spacing adequate). c) Show height of partition and suspended ceiling, and height from floor to roof framing or floor framing. 4. Please imprint on the plans the City of Carlsbad Policies and Procedures for Roof Mounted Equipment to the plans. 5. Please provide the correct electrical plans for suite 301 the plans included were for suite 300. 6. Please note on the plans "AC Cable is not allowed in A, B, E, H, and I occupancies. NM cable is restricted (without City approval) to one and two family dwellings. Note on plans that an equipment ground conductor is to be installed in all flexible conduits". City of Carlsbad O5-3457 lO/15/05 To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please indicate: Yes Q No a The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Doug Moody at Esgil Corporation. Thank you. CITY OF CARLSBAD POLICIES AND PROCEDURE NUMBER: 80-6 EFFECTIVE: 5/1/92 SUPERSEDES:80-6(9/10/80) 80-6(5/01/81) SUBJECT: ROOF MOUNTED EQUIPMENT SECTION: BUILDING DEPARTMENT PURPOSE: INTENT: PROVIDE INSTALLATION STANDARDS FOR ALL ROOF MOUNTED EQUIPMENT AND PENETRATIONS ON COMMERCIAL AND INDUSTRIAL BUILDINGS. A. Maintain roof integrity. B. Prevent hazardous condition to firemen who must fight fire on the roof. C. Provide an installation that is aesthetically sensitive to the building and the adjoining properties. POLICY: 1. All equipment shall be concealed from view and the design* shall meet the approval of the Planning Department. 2. AH equipment shall be specifically designed and approved for exterior use and shall be approved by the City of Carlsbad Building Department. 3. All roof mounted equipment shall be on a platform which shall be an integral part of the roof-flashed and waterproofed. When a screen is approved, it shall have as few roof connections as possible and be structurally adequate. 4. All electrical, plumbing, mechanical duct work and related piping shall be inside the building and not on the roof. All connections related to equipment shall be made in the same roof opening on the platform or have the prior approval from the building official. 5. Sewer vents shall be brought to one main vent below the roof and have one penetration where restrooms or other plumbing fixtures are back to back or in the general proximity. Air exhaust fans and other equipment shall be within the building and use the same roof opening where restrooms and other equipment are back to back or in general proximity. 6. Existing buildings and equipment, remodel or replacement, shall meet the above regulations or shall have the prior approval from the building official. 7. Where new equipment is installed, unused or abandoned equipment, including all roof mounted piping, electrical, mechanical, duct, and other related appurtenances shall be removed from roof and unused openings properly sealed to maintain roof integrity. *The architect should, through design, conceal the heating/AC unit and other equipment whether they are on the roof or elsewhere. dated By:Approved B City of Carlsbad O5-3457 ID/IS/05 VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK NO.: 05-3457 PREPARED BY: Doug Moody DATE: 10/15/05 BUILDING ADDRESS: 2815 Jefferson Street Suite 301 BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: V1H BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA ( Sq. Ft.) 735 cb Valuation Multiplier City Valuation .. By Ordinance Reg. Mod. VALUE ($) 26,180 26,180 $226.31 Plan Check Fee by Ordinance Type of Review: Q Repetitive FeeRepeats Complete Review D Other j—I Hourly Structural Only Hour Esgll Plan Review Fee $147.10 $126.73 Comments: Sheet 1 of 1 macvalue.doc PUNNlNC/ENCINgERlNC APPROVALS PERMIT NUMBER CB DATE ADDRESS RESIDENTIAL TENANT IMPROVEMENT / RESIDENTIAL* AODITIOWMINOR f< $-10.000.001 PLAZA CARUNQKCAC CARUBAD COMPANY STORES VILLAGE FAIRS COMPLETE OFFICE.BUILDINC OTHER PLANNER DATE ENGINEER DATE Carlsbad Fire Department Plan Review Requirements Category: TI, INDUST // Date of Report: 10-05-2005 Reviewed by: Name: SMITH CONSULTING Address: Permit #: CB053457 Job Name: KENT JESSEE-748 SF SHELL TO Job Address: 2815 JEFFERSON ST CBAD St: 301 INCOMPLETE Tho itom you have aubmittod for roviow is inoomploto. At thio time, thio office cannot adequately conduct a review to dotormino compliance with the applicable codeo and/or otandardot Please review carefully all comments attached. Please resubmit the necessary plane and/or cpecificationc, with changec "clouded", to thig office for roviow and approval. Conditions: Cond: CON0000775 [MET] APPROVED: 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. Entry: 10/05/2005 By: GR Action: AP EsGil Corporation In Partnership -with government for (Building Safety DATE: 11/16/05 Q APPLICANT JURISDICTION: City of Carlsbad Q PLAN REVIEWER Q FILE PLAN CHECK NO.: 05-3457 SET: II PROJECT ADDRESS: 2815 Jefferson Street Suite 301 PROJECT NAME: W. Kent Jessee and Associates Suite 301 - TI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: X] Esgil Corporation staff did not advise the applicant that the plan check has been completed. 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 REMARKS: By: Doug Moody Enclosures: Esgil Corporation D GA D MB D EJ ' D PC 11/8/05 trnsmtl.dot 9320 Chesapeake Drive, Suite 208 * San Diego, California 92123 + (858)560-1468 * Fax (858)560-1576 \ TITLE 24 REPORT Title 24 Report for: W. Kent Jesse Tl - Suite 301 2815 Jefferson St Carlsbad, CA 92008 Project Designer: Smith Consulting Architects 12220 El Camino Real San Diego, CA 92130 858-793-4777 Report Prepared By: Mark E. Richards PE Emery Mechanical Engineering 6653 Cowles Mtn. Blvd. San Diego, CA 92119 (619)464-5348 Job Number: 0518 Date: 9/27/2005 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2001 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC (415) 897-6400. EnergyPro 3J By EnergySoft Job Number 0518 User Number 5944 From: Christina Lowman At: Allenbrooka Insurance Sen/ices FaxlD: Aflenbrooke Insurant To: Starrett Construction, Inc. Date: 1/19/2005 03:25 PM Page: 2 of 2 ACORD. CERTIFICATE OF LIABILITY INSURANCE MgHf.1« PRODUCER Allenbzooke Insurance Services CA License #OB72740 1322 Scott St., Suite #201 San Diego CA 92106 Phone : 619-641-7450 Fax : 619 -641-7455 INSURED Starrett construction Inc.1941-B fi C Friendship Drive El Cajon CA 92020 DATE (MM/DD/YYYY) 01/19/05 THIS CERTIFICATE IS ISSUED AS A MATTER OP INFORMATION ONLY ANDCONFERS 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. hMxiou S»*«ty XndMlnty Co INSURER B: state crapmntien ouuzinci INSURER C: INSURER D: INSURER E: NAICtf COVERAGES THE POL CIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A00VE 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 OH MAT 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. mrr LTR A. B TOUT NSRC TYPE OP INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY j CLAIMS MADE [_X~j OCCUR GEML AGGREGATE LIMIT APPLIES PER' ~~|w«vn5ggr |X~|LOC AUTOMOBILE LIABILFTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE UABILfTY | ANY AUTO EXCESS/UMBRELLA LIABILITY I OCCUR 1 1 CLAIMS MADE J DEDUCTIBLE | RETENTION J WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTMER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yts, describe undtrSPECIAL PROVISIONS bilow OTHER POLICY NUMBER ESL0014290402 1712608 DATE (MMflDD/YY) 04/21/04 'l. 01/01/05 DATE (MM/DD/YY) 04/21/05 01/01/06 LIMITS EACH OCCURRENCE PREMISES (Ea occurtnce) MED EXP (Any on* person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT(Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THANAUTO ONLY EAACC AGG EACH OCCURRENCE AGGREGATE X [TORY LIMITS ! ER E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE E L DISEASE - POLICY LIMIT t 1,000,000 $50,000 i Excluded * 1,000,000 12,000,000 11,000,000 $ * * f t f f f t t I $ 11,000,000 (1,000,000 f 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Proof of Insurance CERTIFICATE HOLDER CANCELLATION EVIOF-1 WOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL EVIDENCE OF INSURANCE ONLX IMPOSE NO OBLIGATION OR LIAB^TY OF ANY KIND UPON THE USURER, ,TS AGENTS OR REPRESENTATIVES. jHTtVffiRliiBTlEPllESENWnVE s—>fc-^te^^*-"'^ ACORD 25 (2001/OS)©ACORD CORPORATION 1988