The URL can be used to link to this page

Home My WebLink About2888 CAMINO SERBAL; ; CB004063; Permit08-23-2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No:CB004063 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2888 CAMINO SERBAL CBAD POOL 2552830200 Lot #: 0 $1,722.00 Construction Type: UN FOSSILE RESIDENCE 56 SF SPA W/GAS FOR BAR-B-QUE Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/03/2000 MDP 11/13/2000 11/13/2000 JL Applicant: AZURE POOL CONSTRUCTION CO 7423 EL CAJON BLVD LA MESA CA 91941 Owner: LACOSTA VALLEY-CARLSBAD L P C/0 HEARTHSTONE 16133 VENTURA BLVD #140*73 08/23/01 0002 01 02 ENCINOCA 91436 CQp Total Fees: $133.54 Total Payments To Date: $113.65 Balance Due: $19.89 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 $39.79 $0.00 $25.86 $0.00 $20.00 $27.00 $1.00 $0.00 $0.00 $19.89 $0.00 TOTAL PERMIT FEES $133.54 Inspector: FINAL APPROVAL Date: t * ^K-0 \Clearance: 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 capactiy 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 aiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION ' * • CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT I FOR OFFICE USE ONLY PLAN CHECK NO.&V MPG3> EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No. Phase No. Total tt of units Assessor's Parcel tt ,Existing Use Proposed Use Description of Work 3, CONTACT FtRSONtHdmerent from applicant) SQ. FT.#of Stories # of Bedrooms # of Bathrooms Name 3, APPLICANT O Contractor Address City for Contractor Q Owner Q Agem for Owner State/Zip Telephone #Fax* Name 4, City State/Zip Telephone # Name Address City State/Zip Telephone # 5. 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 exemption^ Any violation of Section ^703^.5 by anv applicant for a permit subjects the applicant to a civil penalty^of not more than five hundred do[larsj$i500] Name State License tt _ ._ OO l"\ <£> \ Address License Class _ _ \J \V^_ State/Zip City Business License tt Telephone # Address City State/Zip TelephoneDesigner Nan State License # 6. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: [~l 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. ^H 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 issbad. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No.]Expiration (THIS SECTION NEED AOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) ^Hb'\CV O\ l~l CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dol)»iV4$><fp,OQ.O),in adTtitioQ to thacostjat ^SttfRelKation, damages as provided for in Section 3706 of the Labor coda, interest .and attorney's fees. „ „ __„ DATE * ' ^ "'~N 7, OWNER-BUlLDflTDECLAtaTION * I hereby affirm that I am exempWrom the Contractor's License Law"for the following reason: Q 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). 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). C] 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. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE ^S^^w*^:*^iS^wt»i»t'r^(ls^(^^S^^P'**AS^;iii'tSi^^i^«ii^*^**'ji*^^^*iKiMiiBii?iis^^B*»lv» ^n&M w' 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? Q YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q 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. 8, CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9. APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the CitV 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 issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is nlktcommenced within 1 a8"33y»4(om the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is^oVfiTneruieilLfor a periodof ifef/xiayV&ction I06.4.4,bmform Building Code). _ .**. Am^t^JT^J^fflPq^OV^ ™ \\'0?. f)0 City of Carlsbad Bldg Inspection Request For 10/11/2001 Permit* CB004063 Title: FOSSILE RESIDENCE Description: 56 SF SPA W/GAS FOR BAR-B-QUE Type: POOL Sub Type: Job Address: 2888 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: FOSSILE DOMINIC E&KAREN M Remarks: Inspector Assignment: NF si- H-a, Phone: 6196973363 Inspector:A)F Total Time:Requested By: OSCAR Entered By: CHRISTINE CD Description Final Pool Act Comments JP Associated PCRs Date 10/03/2001 08/24/2001 02/02/2001 12/13/2000 12/06/2000 12/06/2000 12/06/2000 12/06/2000 12/05/2000 12/05/2000 Inspection Historv Description 59 Final Pool 59 Final Pool 55 Fence/Pre-Plaster 31 Underground/Conduit-Wiring 23 Gas/Test/Repairs 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing Act CO CO AP AP AP AP AP AP CO CO Insp NF NF GG JL JL JL JL JL JL JL Comments SEE C.N. SEE C.N. ATTACHED CONDUIT ONLY FENCING & GATE NOT IN PLACE EASTSIDE City of Carlsbad Bldg Inspection Request For: 10/03/2001 Permit* CB004063 Title: FOSSILE RESIDENCE Description: 56 SF SPA W/GAS FOR BAR-B-QUE Inspector Assignment: NF Type: POOL Sub Type: Job Address: 2888 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: FOSSILE DOMINIC E&KAREN M Remarks: Phone: 6196973363 Inspector: Total Time:Requested By: OSCAR Entered By: CHRISTINE CD Description 59 Final Pool Act Comments Associated PCRs Inspection History Date Description 08/24/2001 59 Final Pool 02/02/2001 55 Fence/Pre-Plaster 12/13/2000 31 Underground/Conduit-Wiring 1 2/06/2000 23 Gas/Test/Repairs 12/06/2000 51 Excav/Steel/Bonding/Fence 12/06/2000 52 Underground Plumbing 1 2/06/2000 53 Electric/Conduit/Wiring 12/05/2000 51 Excav/Steel/Bonding/Fence 1 2/05/2000 52 Underground Plumbing Act CO AP AP AP AP AP AP CO CO Insp NF GG JL JL JL JL JL JL JL Comments SEE C.N. ATTACHED CONDUIT ONLY FENCING & GATE NOT IN PLACE EASTSIDE CITY OF CARLSBAD BUILDING DEPARTMENT NOTICE (760) 602-2700 1635 FARADAY AVENUE DATE LOCATION PERMIT NO. C-g» TIME ~+ • v \fJ^<4 ' 3 - ! FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? INFORMATION, CONTACT YES PHONE CODE ENFORCEMENT OFFICER -' /tttr City of Carlsbad Bldg Inspection Request For: 08/24/2001 Permit* CB004063 Title: FOSSILE RESIDENCE Description: 56 SF SPA W/GAS FOR BAR-B-QUE 2888 CAMINO SERBAL Lot 0 Type: POOL Sub Type: Job Address: Suite: Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: FOSSILE DOMINIC E&KAREN M Remarks: Inspector Assignment: -H4- Phone: 6196973363 Inspector:. ^JUT Total Time: CD Description 59 Final Pool Requested By: OSCAR Entered By: ROBIN Act Comments Associated PCRs Inspection History Date Description 02/02/2001 55 Fence/Pre-Plaster 12/13/2000 31 Underground/Conduit-Wiring 12/06/2000 23 Gas^est/Repairs 12/06/2000 51 Excav/Steel/Bonding/Fence 12/06/2000 52 Underground Plumbing 12/06/2000 53 Electric/Conduit/Wiring 12/05/2000 51 Excav/Steel/Bonding/Fence 12/05/2000 52 Underground Plumbing Act Insp Comments AP GG AP JL AP JL AP JL AP JL AP JL CONDUIT ONLY CO JL FENCING & GATE NOT IN PLACE CO JL EASTSIDE CITY OF CARLSBAD BUILDING DEPARTMENT NOTICE DATE >^ 3- ^~ 0 ( LOCATION PERMIT NO. OB Q 0 V Od (760) 602-2700 1635 FARADAY AVENUE TIME G.FT. 3.. A^W~**~ -4t FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? I I YES 4, CONTACT PHONE CODE ENFORCEMENT OFFICER City of Carlsbad Bldg Inspection Request For: 12/5/2000 Permit* CB004063 Title: FOSSILE RESIDENCE Description: 56 SF SPA W/GAS FOR BAR-B-QUE Inspector Assignment: Type: POOL Sub Type: Job Address: 2888 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT AZURE POOL CONSTRUCTION CO Owner: Remarks: Phone: 6196973363 Inspector: Total Time: CD Description Act Comments Co51 Excav/Steel/Bonding/Fence 52 Underground Plumbing Requested By: CONNIE Entered By: CHRISTINE / Associated PCRs Inspection History Date Description Act Insp Comments CITY OF CARLSBAD BUILDING DEPARTMENT DATE \7.-g^-OO LOCATION. NOTICE (760) 602-2700 1635 FARADAY AVENUE TIME. PERMIT NO.MQfr^ "To in FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT YES PHONE BUILDING I!TOR CODE ENFORCEMENT OFFICER City of Carlsbad Public Works Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER: CB BUILDING ADDRESS: $&&% CdWfYiA c PROJECT DESCRIPTION: Pool ASSESSOR'S PARCEL NUMBER: fa, 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 changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build. By:Date: DENIAL Please see tha attached report of deficiencies marked with/D/ 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. ATTACHMENTS 0 Grading Permit Application D Grading Permit Checklist D Right-of-Way Permit Application D Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME: TANIYA WADE City of Carlsbad ADDRESS: 1635 Faraday Avenue Carlsbad, CA 92008 PHONE:(760) 602-2773 H:\WORP\POC!aCHKLST>Pnol BujMMn Ptondack CUM CHKM Fnm GMH dne 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2720 • FAX (760) 602-8562 BUILDING PLANCHECK CHECKLIST - POOLS Lo + SITE PLAN Q Q 1. Provide a fully dimensioned site plan drawn to scale. Show: North Arrow Or-Property Lines \r Existing & Proposed Structures D< Easements Q Q 2. Show on site plan: Af Drainage Patterns Dr"lndicate what will happen with B.'"Existing & Proposed Slopes soil excavated from pool area Cr"Existing Topography <-ET"Retaining 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 Q Q 3. Include on title sheet: Site Address Assessor's Parcel Number Legal Description D. Grading Quantities Cut Fill Import/Export 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 1 1 .06.030 of the Municipal code. Q Q Q 5a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill, import, export). Q Q 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 1 of 2 1 ST/ 2ND/ 3R[V Q • D Q 5c. A Grading Permit has been applied for: PE2 DWG Grading Inspector sign off by: _ Date: _ Q 5d. No Grading Permit required. MISCELLANEOUS PERMITS Q 6. A RIGHT-OF-WAY PERMIT is required to do work in Citv Right-of-Wav and/or private work adjacent tot he public Right-of-Way. Li InC) A separate Right-of-Way issued by the Engineering Department is required 0$ ^ 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 Building Permit will be issued simultaneously. 7. Remarks Page 2 of 2 PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Cvf) * ia a Plan Check No. CB Planner APN: Address 8%>&t> Caoo'vno Phone (760) 602- Type of Project & Use: SPA / Zoning: P~C- General Plan: Net Project Density:DU/AC CFD /in/nut) $ Circle One .Date of participation: \2-\JTT\ Facilities Management Zone: \_ Remaining net dev acres:_ (For non-residential development: Type of land used created by this permit: ) I I D D Legend: X. Item Complete Item Incomplete - Needs your action I I Environmental Review Required: YES NO TYPE DATE OF COMPLETION: DD Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: Discretionary Action Required: APPROVAL/RESO. NO. PROJECT NO. YES NO DATE TYPE OTHER RELATED CASES: Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES CA Coastal Commission Authority? YES NO If California Coastal Commission Authority: Contact them at - 3111 Camino Del Rio North, Suite 200, San Diego CA 92108-1725; (619) 521-8036 Determine status (Coastal Permit Required or Exempt): NOCoastal Permit Determination Form already completed? YES If NO, complete Coastal Permit Determination Form now. Coastal Permit Determination Log #: Foliow-Up Actions: 1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum Floor Plans). 2) Complete Coastal Permit Determination Log as needed. H:\ADMIN\COUNTER\BldgPlnchkRevChklst no, . toa 452 6004 Oct. 02 2000 li:07ftM P2 4CO*a CERTIFICATE OF LIABILITY Haterldg* insurance Services 10525 Viaca Sorrento PXwy #300 San Di*go CA THIS CERTtFICATE IS ISSUED AS A.MATThK Ot- INFORMATION ONLY AND CONFERS NO RtGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Micfeael S. Galloway PhoBcMo. 858-452-2200 INSURED 8S8-452-60D4 Bob Z«lly DB&i Axur« Pool Cons truet ton 7423 81 C«jon Blvd. La H«aa CA 91941 COMPANIES AFFORDING COVERAGE COMPANYA ZNSCORP - In* Corp of NY COMPANY8 Stats Ccop«a«atioa Fund COMA4NY D EXJKE8SGES.; TMB IS TO CERTIFY THAT T« POUCCS OF INSURANCE LISTED BELOW HAVE BEEN iSSUCO TO THE M3URED NAMED A60VE FOR THE POLICY PCfeOO MWCATEO. NOTWfTHSTANOWG ANY REQUIREMENT. TERM OR CONDITION Of ANY CC^RACT C* OTHER DOCUMENT VWTW RCS^CCT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE Aff OROSO 8Y THE POUOCS 06SCW8H) HEREIN IS SUBJECT TO AU.T« TERMS. EXICLIjSIONSAI^CONOlTONSOySUCHPOLlCIBSAPanSSHOVWMAYMAVEftEENRa^^ KJOCY NUMBER POUCY6XPIRATIQN X i COMMeRClAt. CENCRALUABCITY I CAIC10017209 "^ ' CLAAISMADC fxl OCCUR $1,000 PD BED. OCCCKSKNCB 09/01/00 09/01/01 GCkflUL ACCHTCATt PtWOOCTS - COMPJOP A(3G PERSONAL « AOV INJURY EACH OCCURRENCE * 2, 000, 000 * 2, 000, 000 (1,000,000 sl,OOP,OOP FRE DAMAGE (Any on* ft«) t 100,000 MED EXP (Any «n« person)50,000 AUTOMOBILE UAWUTY ~1 CAICZ0017209 09/01/03.COM8MEO SINGLE LIMIT $1,000,000 ALL OWMED AUTOS SCHE&UUOAUTOS HIRCDAUTOS NOftOVWEOAUTOS BOOH.V INJURY(P»r person) BOOtLV IHJUftV PROPERTY OMMAGE GARAGE Li»8n.rrY AUTO ONLY. EAACCIOSWT $ ANY AUTO OTHERTHANAUTOONJ.Y: EACHACCneNT excess UAWLITY ! UM8R&1AFORM OTHER THAN UMBRELLA FORMn BACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYEftrUAeiUTY EL EACH ACCIDENT THE PROPRtCTOR/ PARTNfitSCXECUTlVE tNCC XWD 10/01/00 10/01/01 11,000,000 CL DtSCASl - POLICY UMtT $1,000,000 B. OtSEAK- E4 CMPLOVEE * 1,090, 900 OTH6R DESCRIPTION OF OPSR*TION&LOCATIONSA«HIC«-tS^*eCIAl. ITEMS 10 DATS MOTICE FOR ROH-PAYMBHTOP.PHBKITO CERtlFZCAXB &OUD8R^ ADDITZOHftZ. XNSOROT_PBR ATXACKBD FOllK CG2124 WITH RBSPZCT TO ~~LIABILITY OHLY. KBt Att «»BfeATIOw5 PERFO8HBD BY OX ON BBHALF OF THEXHSOKBD (xxx) ••. -. • <• *••;/'.'. ............ .-.-.-...•.-.•-v..cjtvv.w.vAVA'.-:vV:c-":- -x'-x' x*:':'------ «•>•->:' -----v.'.-. •,-.-x.,-.. ..-•••• • • _• ^ ^ ,..NV,,-.,^ ,^>.\.s:. j.-v. .'^. .V.-*- COFSAVS County of San Diego Attn> Bldg. permits Dept. S201 Ruffin. Road. Suiba B Diego CA 92123 SHOULD ANY or Tw«AeoveoHC«iBeoPOi.ic*s BE CAMCSUCO BEFORE T«e EXPIRATION DATE THEREOf. rfife ISSUING COMPANY Wn.1 flHMMMBMML _lfi±_ DAYS WRITTEN NOTICE TB TH8 CeKTVlCATK MOtOBS NAMED to THC LEFT. LLJ CO Jv 4 I El] d] EH Inclusionary Housing Fee required: YES NO (Effective date of Inclusionary Housing Ordinance - May 21, 1993.) Data Entry Completed? YES NO (A/P/Ds, Activity Maintenance, enter CB#, toolbar. Screens, Housing Fees, Construct Housing Y/N, Enter Fee, UPDATE!) Site Plan: I I I I I I 1 . Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of-way width, dimensional setbacks and existing topographical lines. I I | I | I 2. Provide legal description of property and assessor's parcel number. Zoning: D D D 1- Setbacks: Front: Interior Side: Street Side: Rear: Required Required Required Required LJ LJ 2. Accessory structure setbacks: Front: Required Interior Side: Required Street Side: Required Rear: Required Structure separation: Required Shown Shown Shown Shown Shown Shown Shown Shown Shown [ I | I [j 3. Lot Coverage:Required Shown CD ED EH 4- Height:Required Shown EH CH 5- Parking: Spaces Required Guest Spaces Required I I Additional Comments Kto * Shown Shown A nm nroertnroperu OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER H:\ADMIN\COUNTER\BldgPlnchkRevChklst DATE \\k 0'