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Home My WebLink About2815 Levante St; ; CBR2017-1579; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Print Date: 08/02/2017 Residential Permit Permit No: CBR2017-1579 Job Address: Perm it Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: Description: 2815 Levante St BLDG-Residential 2162301600 $0.00 www.carlsbadca.gov Work Class: Demo Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: STEWART: POOL DEMOLITION -NO NEW CONSTRUCTION PROPOSED Owner: Status: Applied: Issued: Fina led: Inspector: Contractor: Closed -Finaled 07/13/2017 07/13/2017 AKrog TRUST STEWART KATHY TRUST 763 Alpine Heights Rd JAMES CONSTRUCTION CLEANUP INC ALPINE, CA 91901 6755 Mira Mesa Blvd, 123-381 San Diego, CA 92121-4307 619-861-6700 BUILDING PERMIT FEE ($0-$500) SWPPP INSPECTION FEE TIER 1 -Medium BLDG SWPPP PLAN REVIEW FEE TIER 1-MEDIUM Total Fees: $352.00 Total Payments To Date: $352.00 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020{a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. $0.00 $65.00 $232.00 $55.00 THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING D ENGINEERING □BUILDING □FIRE □HEALTH D HAZMA TIAPCO l~·~· Building Permit Application Plan Check No.QbR_ z.D\7-\"5 7C\ ~ .~f 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ C1TY 0 F Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit CARLSBAD email: building@carlsbadca.gov www.carlsbadca.gov Date , -\~ -\ 7 lswPPP JOB ADDRESS SUITEf/SPACEII/UNITII 2815 Levante St IAPN 216 -230 -16 -00 CT/PROJECT# rOT# I PHASE# I# OF UNITS r BEDROOMS H BATHROOMS I fi;IIIANT BUSINESS NAME I CONSTR. TYPE I acc. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Properly demo, fill & compact pool with a permit (pool area will not be build-able, & pool walls will not be demoed), "e",o & 1111:11111111, the 111:11, 1'9111111 Iba 2 bh~i;k ~,alla et tlMI "-011+bwest corn11r of 1h11 swA ~n•. Ot1t the co11c1ete aeilk .a 2111111::atc the &hei,e eftha &Ila, ani ianw tba 11111.fiFo pit 11111 llenehes. Painti11a aeeeH ,eil1t Jl8T inel1:Hl11d EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE rlR CONDITIONING I FIRE SPRINKLERS YESO No□ YES0No0 vESONoO APPLICANT NAME (Primary Contact) James Construction APPLICANT NAME (Secondary Contact) Jennifer/Randy Cole ADDRESS ADDRESS 6755 MIRA MESA BLVD #123-381 9880 Maqnolia Ave #119 CITY STATE ZIP CITY STATE ZIP San Dieqo CA 92121 Santee CA 92071 PHONE IFAX PHONE I FAX 619-405-2648 619-330-4796 EMAIL EMAIL jennifer@permitrunner.net PROPERTY OWNER NAME Vertical Infill, Inc CONTRACTOR BUS. NAME James Construction ADDRESS ADDRESS 2815 Levante St 6755 MIRA MESA BLVD #123-381 ~ CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92009 SAN DIEGO CA 92121 PHONE rAX PHONE IFAX (760) 525-8291 EMAIL EMAIL ARCH/DESIGN ER NAME & ADDRESS I STATE LIC, # STATE uc:# rLASS. 1 CITY BUS. UC.# 802538 D63/C21 1236197 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct. alter, ,mprove, demolish or repair any structure, prior to 1ts issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the prov1s1ons of the Contractor's License Law [Chapter 9, commendinl! with Section 7000 of Division 3 of the Business and Professions Code] or that he 1s exempttherefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicanffor a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500]}. WORKERS' COMPENSATION Worken' Compentatlon Declaration: I hereby affirm under penaHy of perjury one of the following declarations.· D I have and will maintain a certificate of consent to 1elf.in1ure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. - D t have and will maintain wor11ers' 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~ Employee Service Group --Policy No W101783200 Expiration Date 41112018 ~section need not be completed if lhe permit is for one hundred dollars ($100] or less LJ Certificate of Eiemption: I certify that in the performance of the wolk 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 wolken' compensation co e 11 unlawful, and shall subject an employer to criminal penalties and civil flnn up to one hundred lhou11nd dollars (&100,000), in addition to the cost of compensauon, damages 11 rovlded for i O)'I 3706 of the Labor code, interest and attorney's fees. kf CONTRACTOR SIGNATURE I hereby aff,mi that ram exempt from Contractor's License Law for the following reason: □ □ □ I, as owner of the property or 111)1 employees with wages as their sole compensation, will do the walk and the structure is not inlended 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 wolk himse[ 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 buroen of proving that he did not build or improve for the purpose of sale) I, as owner of the property, am exclusively contracting with licensed contractors to construct the projec1 {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 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. OYes 0No 2. I {have/ have not) signed an application for a building permit for the proposed wort<. 3. I have contracled with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number): 4. I plan to provide portions of the wolk, but I have hired the following person to coordinate, supervise and provide the maJor walk [include name I address I phone I contractors' license number): 5. I will provide some of the walk, but I have contracted I hired) the following persons to provide the work indicated (include name I address I phone I type of work): kf PROPERTY OWNER SIGNATURE □AGENT DATE I I COMPLETE THIS S.ECTJON FOR NON-RESIDENTIAL BUILDING PERMJTS ONLY Is the applicant or future building occupant required lo 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 lo obtain a pem,it 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 tF 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. C O N S T R UC T l O N L E N O I N G · A ,G E N CY ·. I hereby affirm that there is a construction lending agency for the performance of the worn this permit 1s 1ssue<:1 (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I c:ertlfy1hatl haw read Ille application and statelhattheallollelnfomlation ls correct and that the inlbnnation on Ille plans isaccurala. I agreetc complywith all City ordinances and State laws relatingmbulldlngconstruction. I hereby au1horize represenlalM! of the City of CMSbad to enter upon 1he above mentioned property for i1specoon pu1JJOS€S. 1 ALSO AGREE TO SAVE, INDE~IFY AND KEEP HARlvV..ESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH fiMY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations r:Ner: 5'0' deep and demolioon or construction of s1ructures r:Ne< 3 sfllries in height. EXPlRA TION: Eveiy permit issued by the Building OffiCiaj under the pfO'l'isions of 111· e shall expire by lmltation and become null and void W the buildi1g or work ao1holized by such permit is not commenced Yoithin 180 days from the date of such permit or if 1he building or work lhorized by it is suspended or abandoned at any time after lhewcrk is commenced for a period of 180 days (Section 106.4.4 Unifoon Building Code). ,IS APPLICANT'S SIGNATURE DATE 7/12/17 ~ / " ~ . · .. ·:·:. '. . , F?ERMIT INSPECTION HISTORY REPORT (CBR2017-1579) Permit Type: Work Class: Status: Scheduled Date BLDG-Residential Demo Closed -Finaled Actual Start Date Inspection Type Application Date: 07/13/2017 Owner: TRUST STEWART KATHY TRUST Issue Date: 07/13/2017 Subdivision: LA COSTA SOUTH UNIT #4 Expiration Date: 01/15/2018 Address: 2815 Levante St Carlsbad, CA 92009-8123 IVR Number: 4998 Inspection No. Inspection Status Primary Inspector Reinspection Complete ---·-··•-··--~---·-· '"""'·---·-·-------------------·---------------- 07/17/2017 07/17/2017 07/1812017 07/18/2017 07/1912017 0711912017 07/25/2017 07125/2017 08/02/2017 08/02/2017 August 02, 2017 BLDG-SW-Pre-Con 028882-2017 Checklist Item BLDG-Building Deficiency BLDG-SW-Pre-Con 028992-2017 Checklist Item BLDG-Building Deficiency BLDG-51 Excav/Steel/Bonding /Fence(Poolsl 029204-2017 Checklist Item BLDG-Building Deficiency BLDG-Final 029652-2017 Inspection Checklist Item BLDG-Building Deficiency BLDG-Final 030590-2017 Inspection Checklist ltem BLDG-Building Deficiency BLDG-Building Deficiency Cancelled Andy Krogh COMMENTS Passed Andy Krogh COMMENTS No card onsite Partial Pass Paul York COMMENTS Failed Michael Collins COMMENTS No contractor or Job card on site. Passed Michael Collins COMMENTS No contractor or job card on site. Equipment removed, No structures allowed over former pool location without soils report submittal. Reinspection Complete Passed No Complete Passed Yes Re inspection Incomplete Passed No Re inspection Complete Passed Na Complete Passed No Yes Page 1 of 1 ~ «<#,> .. CITY OF CARLSBAD STORM WATER COMPLIANCE ASSESSMENT B-24 Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov I am applying to the City of Carlsbad for the following type(s) of construction permit: oi:I Building Permit □ Right-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: Patio/Deck Photo Voltaic Re-Roofing Sign Spa-Factory Sprinkler Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Water Discharge Project Storm Water Threat Assessment Criteria* No Threat Assessment Criteria D 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 ner Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. Tier 1 -Low Threat Assessment Criteria D 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 of the following criteria• • Results in some soil disturtiance; and/or • Includes outdoor construction activities (such as saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling). Tier 2 • Moderate Threat Assessment Criteria ]O My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturbance including any associa1ed 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). Tier 3 -Significant Threat Assessment Criteria D My project includes dearing, 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 D 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, D 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 neartiy receiving waters by way of storm water runoff or non-storm water discharge(s). I certify to the best of my knowledge that the above checked statements are true and correct. I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the parmit type(s) check above comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to CilV Standards. 'The City Engineer may authorize minor vsnances from the Storm Water Threat Assessment Criteria in special circumstances where il can be shown that a lesser or higher Construction SWPPP ner Level is warranted. B-24 2815 Levante St.Carlsbad, CA c2, City Concurrence: □YES □NO Page 1 of 1 By: Date: Project ID: Rev.03/09 «~~ ~ CITY OF CARLSBAD 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.gov/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. STEP1 TO BE COMPLETED FOR ALL PROJECTS To determine if your project is a priority development project, please answer the following questions: YES NO 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 X paved streets or roads; OR (3) designed and constructed with permeable pavements or surfaces in accordance with USEPA Green Streets auidance? 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? X 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 «~~ ~ C I TY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov STEP2 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 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 orivate 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 oublic develooment oroiects on oublic or orivate 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 parkina or storaae of motor vehicles used persona/Iv 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 comminales with flows from adiacent 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 dav. 1 0. ls 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. ls 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%? NO X X X X X X X X X X X If you answered "yes" to one or more of the above questions, you ARE a priority development project and are therefore subject to implementing structural Best Management Practices (BMP's) in addition to implementing Standard Storm Water Requirements such as source control and low impact development BMP's. A Storm Water Management Plan (SWMP) must be submitted with your application(s) for development. Go to step 3 for redevelopment projects. For new projects, go to step 4 at the end of this questionnaire, check the "my project meets PDP requirements" box and complete applicant information. 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 CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 STEP3 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov TO BE COMPLETED FOR REDEVELOPMENT PROJECTS THAT ARE PRIORITY DEVELOPEMENT PROJECTS ONLY Comolete the auestions below reaardina vour redevelopment project: YES Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than I I 50% of the surface area of the oreviouslv existina 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. NO If you answered "no," the structural BMP's required for Priority Development Projects apply to the entire development. Go to step 4, check the "mv oroject meets PDP reauirements" box and complete annlicant information. STEP4 CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT INFORMATION (X) My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater criteria per the SUSMP and I understand I 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. 0 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 Address 2815 Levante St..Carlsba'tJ __ Applicant Name: J {, 1 .Dr'L, Applicant Sig~/uJ7fJ \ / Accessor's Parcel Number(s): 1 /-,7-, .:i. /(a -.J. 0 0 -/6-lA/ Applic~ Title:J ~I✓- Date: 'i-/ 3>-1] This Box for City Use Only City Concurrence: I YES I NO I I By: Date: Project ID: • Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their 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 «~~ ~ CITY OF CARLSBAD STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 This form is required for all pools, retaining walls or whenever a building footprint is enlarged. 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 feel of an environmentally sensitive area with a significant potential for contributing pollutants to nearby receiving waters by way of stonn 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 of the 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 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). 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. OWNER(S)/OWNER'S AGENT NAME (PRINT) OWNER(S)/OWNER'S AGENT NAME (SIGNATURE) DATE 'E-29 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 Page 1 of 3 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov PROJECT INFORMATION Site Address:~ 8" /9 L(,: 1/M/(..... Assessor's Parcel Number: .;). I{:> -_:i 3? ~) Project ID: ___________ _ Construction Permit No.: _______ _ Estimated Construction Start Date 1J1zlt ~ , Project Duration 3 -5 daysM~- Emergency Contact: Name: Bill Stults 24 hour Phone: (619) 861-6700 Perceived Threat to Stonn Water Quality 0 Medium ~ 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 By: _________ _ Date: _________ _ REV 4/30/10 -IJJ Erosion Control Tracking Non-Storm Water Waste Management and Materials BMPs Sediment Control BMPs Control Management BMPs Pollution Control BMPs BMPs C C C E -0 :§ i C: ,:, Cl) ,:, Cl) C u C: a, E C E ,:, .fl (ll 2 2 0 .S C, C. Ill Cl) C: J!l Ill "' § :; "O .E Ill ~ "O Q) C, G) -a; ii; ii; C: ·5 c:-C, Ill $ a, c:-Cl. Cl) C: ~ Ill ~ c'.5 'i:: O" Cl) Ill C: Best Management Practice C: a)~ ·5. -~ C "' C w -~ C: ~ ~ "' 1115 :c Ill !!! IIl 0 Cl) 0 CD ~ Cl) Ill (ll (BMP) Description ➔ "' 0 ;w C I-E a, al g, IIl C o-0 "' "O t) a:; Ill ~ c::: J!l "' ~ ..!!l "S -~ Cl) (ll .!!1 (II "ffi C al~ "O C C ~ C 0 ::, Cl) Ill ::l ~ Cl) u c Cl 0 tll ~ --C, -0 >, 0 «I iJ ..!!l ,,_ m 0 Cl) ~ :ie w E Cll m 0 il e Cl a, 0 C QJ Cl'.'. (ll 0 --N t/l li ~ (I) ~J ro ·5. ~ "E i (ll CD E .x 1i -::l .c E~ ="' -. a, :c -~ --0 _,;;; C 8. IL '-' ai ,,_ CD ::l "O :c e --""C .Sl C $ .x ~ (II u 0 t:: ---'c (I) m il! '-' C _g e .c (ll ·s: .l9 ai ~ ~ C CD 0 (ll ~ .Q CD ;;;;; .c (II .l!I a, .l9 0 m ~c 0 m o, 0 ~ c'5 -m ~I C) WO r/) (/) (/) (.) u:: (/)> rn (/) (l_ (/) ..s (/) Cl'.'. (l_ >0 ~ :::: rn rn. J:. t). CASQA Designation ➔ .... a:, q, ... ... <') 'i "? '9 I'--co 0 ... ~ ... "'1 .... a:, ... N ('") 'i l.n '9 "i' u ... LU w LU LU ... rr. Ji Ji :i :i I :i (.) 0 ' w w UJ LU Cl'.'. rn Cl) ~ ~ ~ :::: w w w 0 (/) (/) (/) (/) Cl'.l (/) r/) I-I-z z z z ~ ~ ~ ~ ~ ~ ~ Construction Activity w Cl'.l Gradinci/Soil Disturbance X X X Trenching/Excavation Stockoilinci X X X Orillina/Boring Concrete/Asphalt Saw cuttinQ Concrete flatwork Pavinci Conduit/Pipe Installation Stucco/Mortar Work Waste Disoosal Sta11inQ/Lay Down Area )( :Y y Equipment Maintenance and Fueling Hazardous Substance Use/Storai:ie 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 construclion. 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 where 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 lo 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 with 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 with Plastic" column. To learn more about what 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 Stormwater 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 ., 7' -----x __ 'a~ cf WovK,: \JQ.,f'(\o 0-.nci 'h l( pol)\ CUlcl Spev I I '2,oX:58 ) 8 l Ci Leva..V\ te Sl Cc11·ds kd, CA qzoo<f .JUL 13 2017 Lev~,,._te. S'+_ Q,5{Z 20\1-\~·79