The URL can be used to link to this page

Home My WebLink About2852 CAMINO SERBAL; ; CB050208; Permit05-03-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CB050208 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2852 CAMINO SERBAL CBAD POOL 2552812500 Lot#: 0 $19,600.00 Construction Type: NEW SHAFFER RES 560 SF POOL/SPA URE POOL CONSTRUCTION CO Status: ISSUED Applied: 01/21/2005 Entered By: SB Plan Approved: 02/02/2005 Issued: 02/02/2005 Inspect Area: JM 7423 EL CAJON BLVD LA MESA CA 91941 Owner: SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04 2852 CAMINO SERBAL CARLSBAD CA 92009 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES $176.69 $0.00 $114.85 $0.00 $20.00 $27.00 $1.96 $0.00 $0.00 $60.00 $0.00 $400.50 Total Fees:$400.50 Total Payments To Date:$340.50 Balance Due:$60.00 BUILDING PLANS IN STORAGE ATTACHED 7347 05/03/05 0002 01 02 CGP 60-00 Inspector:JK NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you 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 oreviouslv been ctiven a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise expired. 02-02-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Right of Way Permit Permit No: RW050023 Job Address: Permit Type: Parcel No: Start Date: Insurance Expire: 2852 CAMINO SERBAL CBAD References: Location: ROW 2552812500 10/01/2005 Liability Insurance: Y Subtype: MINOR Lot #: 0 Est Complete Date: Traffic Control Plan: Y GOP: CB050208 Project Title: SHAFFER RESIDENCE Description: , POOL & SPA ,.•-"""'" '"'"--. 1Splicant: \ y 'AZURE POOL CONSTRUCTION CO/' *23 EL CAJON BLVD ,- "" LAlvTESA.CAm944- - Status: ISSUED Applied: 01/28/2005 Issued: 02/02/2005 Expired: 08/01/2005 Entered By: TNKB Total Fees: $265.00 Total Payments To Date: Permit Fee Additional Permit Fee Other Additional Fees $0.00 Balance Due: $265.00 $0.00 $0.00 $0.00 $265.00 TOTAL PERMIT FEES $265.00 0921 0002 01 02 265 .00 This permit may be revoked by the City Engineer if it is deemed that inadequate progress is being made towards the completion of the work or if the work does not meet City Standards. The applicant may be billed for the cost of any corrective work that the City must perform. Permit Release Date Released Cash Deposit? YOU MUST CALL UNDERGROUND SERVICE ALERT (1-800-422-4133) TWO WORKING DAYS PRIOR TO WORK. UNDERGROUND SERVICE ALERT NO. IF ANY EXCAVATION OR BORING IS DONE. . THIS PERMIT IS INVALID WITHOUT THIS NUMBER PERMir APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 i. FOR OFFICE USE O PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date I U Address (include Bldg/Suite #)Business Name (at this address)014? ui/21/05 uOO/ Oi Legal Description -2.SB - ?.fM - Lot No.Subdivision Name/Number Unit No.# of urfft4 „ 35 Assessor's Parcel #Existing Use Proposed Use Description of Work SO. FT.#of Stories # of Bedrooms # of Bathrooms 2: COMTACT / Name 3. APPLICANT O Contractor Address ^J City for Contractor O Owner Q Agent far Owner // V // State/Zip lepnone # Fax #~ Name 4. PROPERTY OWNER Address City State/Zip Telephone # featft Name Address City State/Zip TeWphane # ft- CONTRACTOR-COMPANY NAME '"'•' (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law '(Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five/iundred dollars [$500]). fName State License # Address - License Class v? ' \ C ' Si 3 City State/Zip ' City Business License # [ C—\ 'Telephone # Designer Name Address City State/Zip Telephone State License # 6. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. Q\ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My worker's compensation insurance carrier and policy number are: Insurance Company T^v&.'T^y \^(.A f)<^A Policy No. jC? l&fi fr^MO^3 Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 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. . JQi workers' com tige-,,-ii unlawful, and shall subject an employer to criminal r lerfsi tion, damage* as provided for In Section 3706 of the Lai DATE ties and civil fines up to one hundred e. interest and attorney's fees. s Licence Law for the following reason: 'ages as their sole compensation, will do the work and the structure is not intended or offered for sale WARNING: thousand dollars SIGNATURE ?, OWNER-ButDEVDECLARA>TiON I hereby affirm that I am exempt from the Contract [~| I, as owner (Ofvjhe property or my employees (Sec. 7044, Business ihd Professions Code: The Contractor's License Law does not apply to an owner of property whojttrifa's or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offeredIfgtaateTlf, 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 builsLariffTprove for the purpose of sale). l~l I, as owner of the property/Vn exclusively contracting with licensed contractors to cojMtfGct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap>|y to an owner of property who builds orJpaertSves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). d I am exempt under Section _"B*i$4ness and Prgf0Mt8ns Code for this reason: 1. I personally plan to provide the major labor andrpaWflStvfor construction of the proposed property improvement. Q YES QNO 2. I (have / have not) signed an applicatipp-ftfra building permitTrbXhe proposed work. 3. I have contracted with the fgjlewtng person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to providj-ptfrtions of the work, but I have hired the following person to coortttqate, supervise and provide the major work (include name / address / phone number / contractors license number): ^X^ 5. I wiWprovide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of wfirk): PROPERTY OWNER SIGNATURE Is the applicant or future ISiilding occupant required to submit a business program under Sections 25505T2S63^or 25534 of the Presley-Tj DATE NO RE YES, A FINAL CERTIFICATE OF OCCl HE OFFICE OF EMERGENCY SERVICES AND THE AIR hazardous materials registration form or risk management and prevention iazardous Substance Account Act? D YES Q NO n a permit from the air pollution control district or air quality management district? Q mdary of a school site? Q YES Q NO MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE ION CONTROL DISTRICT. li* *••. Is the applicant or future building occupant re Is the facility to be constructed withJD^HOOO feet of the IF ANY OF THE REQUIREMENTS OF 8, CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS CERTIFICATION - - - " - ....... " • - . ..,,..,-•'.":", I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the 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 permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit ii authorized by such permit is n at any time after the work is APPLICANT'S SIGNATURE by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work te of such permit or if the building or work authorized by such permit is suspended or abandoned Jon 106.4.4 Uniform Building Code). DATE PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/29/2005 Permit* CB050208 Title: SHAFFER RES 560 SF POOL/SPA Description: Inspector Assignment: JM Type: POOL Sub Type: Job Address: 2852 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04 Remarks: Phone: 6197872320 Inspector: Total Time: CD Description 59 Final Pool Requested By: KEN Entered By: CHRISTINE Act Comment <3 Associated PCRs/CVs Inspection History Date Description Act Insp Comments 05/06/2005 55 Fence/Pre-Plaster AP JM ok to plaster 05/04/2005 55 Fence/Pre-Plaster CO JM 05/02/2005 55 Fence/Pre-Plaster NS JM 04/29/2005 55 Fence/Pre-Plaster CO JM 04/28/2005 55 Fence/Pre-Plaster CO JM 04/15/2005 53 Electric/Conduit/Wiring PA JM 04/14/2005 23 Gas/Test/Repairs AP JM 04/14/2005 31 Underground/Conduit-Wiring PA JM 04/12/2005 51 Excav/Steel/Bonding/Fence AP JM 03/31/2005 51 Excav/Steel/Bonding/Fence CO JM 03/11/2005 51 Excav/Steel/Bonding/Fence AP JM 03/11/2005 52 Underground Plumbing AP JM RECEPTICLE LESS THAN 10FT REINSPECTION FEE DUE ELEC NOT COMPLETE PAY $60 REINSP FEE EXPOSE LIGHT NICHES - ALARMS OK ON 4/14/05 EQUIP/BBQ/FPLACE CONDUIT ONLY OK TO GUNITE POOL SLIDE SLIDE NOT PER DETAIL OK TO GUNITE POOL/SPA (2) LIGHTS EQUIP/MAT/SLIDE City of Carlsbad Bldg Inspection Request For: 05/04/2005 Permit* CB050208 Title: SHAFFER RES 560 SF POOL/SPA Description: Inspector Assignment: JM Type: POOL Sub Type: Job Address: 2852 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04 Remarks: Phone: 6196973363 Inspector: Total Time: CD Description 55 Fence/Pre-Plaster Requested By: OSCAR Entered By: CHRISTINE Act Comment Associated PCRs/CVs Inspection History Date 05/02/2005 04/29/2005 04/28/2005 04/15/2005 04/14/2005 04/14/2005 04/12/2005 03/31/2005 03/11/2005 03/1 1/2005 Description 55 55 55 53 23 31 51 51 51 52 Fence/Pre-Plaster Fence/Pre-Plaster Fence/Pre-Plaster Electric/Conduit/Wiring Gas/Test/Repairs Underground/Conduit-Wiring Excav/Steel/Bonding/Fence Excav/Steel/Bonding/Fence Excav/Steel/Bonding/Fence Underground Plumbing Act NS CO CO PA AP PA AP CO AP AP Insp JM JM JM JM JM JM JM JM JM JM Comments REINSPECTION FEE DUE ELEC NOT COMPLETE PAY $60 REINSP FEE EXPOSE LIGHT NICHES - ALARMS OK ON 4/14/05 EQUIP/BBQ/FPLACE CONDUIT ONLY OK TO GUNITE POOL SLIDE SLIDE NOT PER DETAIL OK TO GUNITE POOL/SPA (2) LIGHTS EQUIP/MAT/SLIDE CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE LOCATION PERMIT NO. (760) 602-2700 1635 FARADAY AVENUE ' jr FOR INSPECTION CALL (760) 602-2725. RE-INSPE£TION FEE DUE? FOR FURTHER INFORMATION, CONTAC YES PHONE CODE ENFORCEMENT OFFICER City of Carlsbad Bldg Inspection Request For: 03/31/2005 Permit* CB050208 Inspector Assignment: JM Title: SHAFFER RES 560 SF POOL/SPA Description: Type: POOL Sub Type: Phone: 6196973363 Job Address: 2852 CAMINO SERBAL Suite: Lot 0 Location: Inspector: APPLICANT AZURE POOL CONSTRUCTION CO Owner: SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04 Remarks: STEEL FOR THE SLIDE Total Time: Requested By: OSCAR Entered By: CHRISTINE CD Description Act Commerjt 51 Excav/Steel/Bonding/Fence t Associated PCRs/CVs Inspection History Date Description Act Insp Comments 03/11/2005 51 Excav/Steel/Bonding/Fence AP JM OK TO GUNITE POOL/SPA (2) LIGHTS EQUIP/MAT/SLIDE 03/11/2005 52 Underground Plumbing AP JM CITY OF CARLSBAD BUILDING DEPARTMENT/ DATE OTICE (760) 602-2700 1635 FARADAY AVENUE LOCATION PERMIT NO. FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURJtlER INFORMATION^ CONTACT _ YES PHONE CODE ENFORCEMENT OFFICER City of Carlsbad Public Works — Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER: CB BUILDING ADDRESS: PROJECT DESCRIPTION: Pool ASSESSOR'S PARCEL NUMBER: ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved. The approval is based on plans, information and/or specifications provided in your submittal; therefore, any changea'loTthese items after this date, including field modjftcationB, must be reviewed by this office to insure continued/conformance with applicable codes. Please r/view carefully all comments attached, as failure/to coinpJjcjwim instructions in this r^pogt car result inAuspeaaK/hpf permit to/build. By:Date: DENIAL Please see the-x attached report of deficiencies marked wHQ^f Make necessary corrections to plans or specifications for compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. By: By: Date: Date: Date: ATTACHMENTS Grading Permit Application Grading Permit Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME: Taniya Barrows City of Carlsbad ADDRESS: 1635 Faraday Avenue Carlsbad, CA 92008 PHONE:(760) 602-2773 H:\DevekJpnnnt SeivkWVMASTERSVFORMS -\CHECKLISTS -\BUILD1NG PIANCHECK CKL1ST FORM - POOLS.OOC Rev. 8/22/96 1635 Faraday Avenue • Carlsbad, CA 92OO8-7314 • (760) 602-2720 • FAX (76O) 6O2-8562 - 3/f- BUILDING PLANCHECK CHECKLIST - POOLS SITE PLAN 3RD/ G 1. Provide a fully dimensioned site plan drawn to scale. Show: •ATjiJorth Arrow 6r Property Lines -BTExisting & Proposed Structures .Dr-^asements 2. Show on site plan: fy Drainage Patterns /TjT^-hlclicate what will happen with (ing & Proposed Slopes J^^ soil excavated from pool area <isting Topography E^^etaining Walls (location and height) Note: If excavated soil is not to be removed from property but regraded on site, show proposed elevations and slopes. If any portion of retaining walls are over 4' in height, a separate permit is required. Retaining Wall Permit CB Applied for Approved 3. Include on title sheet: AT Site Address ^.Assessor's Parcel Number ^0f Legal Description D. Grading Quantities Cut Fill Import/Export a) If grading is not required, write "No Grading" on plot plan. Q Q Q 4. Project does not comply with the following Engineering Conditions of approval for Project No. Conditions were complied with by: Date: GRADING PERMIT REQUIREMENTS The conditions that invoke the need for grading permit are found in Section 11.06.030 of the Municipal code. G G G 5a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill, import, export). Q G Q 5b. Grading Permit required. A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached. Note: The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Page 2 of 3 H:\Devetopmenl S«vlcMtMASTERS\FORMS -^CHECKLISTS -\BUILDING PLANCHECK CKLIST FORM - POOLS.doc Rev. 8/22/16 PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB '• Z&&DATE MDBBSS 5" 2-I NO IDENTIAL ( ^ RESIDENTIAL ADDITION MINOR « $1O,OOO.OO) TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE 10/04/2004 16:26 FAX 6196991372 DRIVER ALLIANT 1001/001 ACOR& 3DUCCR Driver Alllant Insurance Cory Doucette 1620 Fifth Avenue San Diego, CA 92101 619-238-1828 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 'AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPAN* A Interstate Fire & Casualty Co. INSURED COMPANY B Golden Eagle State Compensation Ins. Fund Azure Pool Construction, Inc. 7423 El Cajon Blvd. La Mesa CA 91941-3401 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE CATS (MM/BO/YV) POLICY EXPIRATION DATE (MM/PD/TY)UNKT9 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY _J CLAIMS MADE [ X | OCCUR OWNEH'5 « CONTRACTOR'S PROT CLP6266835 10/01/04 10/01/OB GENERAL AGGREGATE PRODUCTS - COMP/OP AGO PERSONAL « ADV ihJUAY EACH OCCURRENCE FIRE DAMAGE lAny one fire) MED EXP (Any 009 (Mryml 2000000 2000000 1000000 1000000 looooo 5000 AUTOMOBILE LIABILITY CBP9695046 10/01/04 10/01/05 ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT 1000000 BODILY INJURY IPtrpanDn) BODILY INJURYIP»r «tidantl PROPERTY DAMAGE OARAGE LIABILITY ANY AUTO AUTO ONLY • EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE AGGREGATE I WC 5TATU- II TORY LIMITS I _WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 169066403 10/01/04 10/01/05 ft. EACH ACCIDENT 1900000 THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: INCL EXCL EL DISEASE • POLICY LIMIT 1004000 EL DISEASE - EA EMPLOYEE »1000000 OTHER y ttii^l/' DESCRIPTION OF OKRATIONS/LOCATlONS/VEHICLEE/SPECIALjTEMS PROOF OF INSURANCE. ^ jl FOR INFORMATION PURPOSES QN>Y, ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE RT10N GATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 3CL PAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF Aflt KIND JJPON THE COMPANY. ITS AGENTS OR REPHE86NTATIVE8. N OQ I s ICO 6 v-n SD POLtCYHOLDER COPY P.O. BOX" 807; SAN FRANCISCO,CA 94T42-08"O7 INSUFtANC^E ' , - ' - FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 07-01-2004 CONTRACTORS STATE U CENSE BOARD SD WORKERS1" COMPENSATION UNIT P 0 BOX 26000 : f SACRAMENTO CA 95826 , - GROUP: POLICY NUMBER: 1733719-2004 CERTIFICATE -IDt 2 CERTIFICATE EXPIRES: 07-01-20O5 » 07-01-^20^4/07-01-2005 I f LICENSE MOMfifER: #650724INCEPTION DATE.- 07-01-2004D.o.: >s& This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. -. We will also give you to days' advance notice should this policy be cancelled prior to its normal expiration. > - * ? This certificate of insurance is n<jt an insurance policy and does not amend,-extend or alter the coverage afforded by the policies listed hereio.,Notwithstanding any requirement term, or condition-of any contract or other document with respect to which this certificate of * insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions" of such policies. , < AUTHORIZED I^PRESENTATIVE PRESIDENT E«W»LOYER'S LIABILITY LJCM1T INCLUDING DEFENSE COSTS: $1,OOO *OOO.OO PER OCCURRENCE. EMPLOYER LEGAL NAME THE PALM COMPANY, 395 SUNSET OR ENCINITAS CA TWO- TOGETHER, LLC AND/OR COOMES, CARL DOUGEAS AND COOMES, JOANNE _„_ 06/17/2004 ^ •A o a i I 8